Sidney Farber Cancer I n s t i t u t e , Department o f P e d i a t r i c s , Harvard Medical School. Boston. MA.-, -----P a t i e n t s w j t h ~e o v e r l o a d oiten.demonstrate s a t u r a t e d Fe b i n d i n g c a p a c i t i e s and low w h i t e c e l l C l e v e l s when measured by s t a n dard techniques.It has been shown t h a t serum Fe i n excess o f t h e Fe b i n d i n g c a p a c i t y ( " f r e e Fe") can be measured i n p a t i e n t s w i t h Fe o v e r l o a d by EDTA b i n d i n g and u l t r a f i l t r a t i o n .We found " f r e e Feu o f 8.2i2.0 ug% i n 15 p r e v i o u s l y unchelated p a t i e n t s w i t h t h a l , compared t o O.liO.l ug% i n normal c o n t r o l s . Since " f r e e Feu m i g h t be a p a r t i c u l a r l y p o t e n t o x i d a n t and t h e r e f o r e r e s p o n s i b l e f o r sane o f t h e patholoqy i n t h a l , and s i n c e C i s thought t o increase t h e r a t e o f t r a n s f e r o f Fe from one pool t o another, we examined 5 o f these p a t i e n t s t o determine t h e e f f e c t o f C and DF on " f r e e Fe". A l l 5 t h a l s had low i n i t i a l w h i t e c e l C l e v e l s . Each r e c e i v e d a l t e r n a t i n g 12-hour continuous I . V . r e g imens o f C alone, s a l i n e , and C + DF w i t h samples f o r " f r e e Feu drawn every 4 hours. Results showed t h a t " f r e e Feu was 9.8i2.3 ~g % d u r i n g s a l i n e i n f u s i o n s and t h a t t h e l e v e l was unchanged hen C was added. When DF was present, " f r e e Feu was e l i m i n a t e d These r e s u l t s show t h a t t h a l s w i t h Fe o v e r l o a d have measurable = amounts o f " f r e e Feu which a r e n o t a f f e c t e d by C. Continuous c h e l a t i o n w i t h DF i s e f f e c t i v e i n e l i m i n a t i n g t h i s p o t e n t i a l l y t o x i c p o o l . Forty-seven of 417 evaluable patients (11%) developed hematuria. The hematuria was moderate or severe in 80% of cases. It occurred with equal frequency throughout treatment and occurred for the first time in some patients after therapy was stopped. Severe neutropenia (<500/mm3) was observed in 67% of patient in Regimen E and 72% of patients in Regimen F (Clinical Groups I11 and IV). Adriamycin cardiomyopathy has not been observed in this study.Since most early deaths occurred in patients with head and neck primaries, the use of less intensive inltial chemotherapeutic regimens may be advisable fc these patients. EHE IThe purpose of this study was to investigate the cause of granulocytopenia in children with acute lymphocytic leukemia (ALL). The double layer agar technique for myeloid colony formation was utilized in a1 studies. Various concentrations of sera from 16 chi1 dren with ALL at the time of diagnosis were added to bone marrow cells in culture. Only 2 sera were observed to produce inhibition of colony formation. Various concentrations of initial bone marrow cells from children with ALL were mixed with normal bone marrow cells and cultured. No inhibition of colony formation was observed in a...
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