A Comparison of Oral Ondansetron and Intravenous Granisetron for the Prevention of Nausea and Emesis Associated with Cisplatin-Based Chemotherapy.

PURPOSE: To compare the efficacy and safety of oral ondansetron with i.v. granisetron each given as a single dose prior to administration of highly emetogenic cisplatin chemotherapy.

Plasmacytoma of the breast. An unusual case of recurrent myeloma.

An unusual case of multiple myeloma is presented in which recurrence of the disease after a four-year remission was heralded by an infiltrating plasmacytoma of the breast. The clinical and histologic features of this neoplasm are presented and compared with ten previously reported cases of plasmacytoma of the breast.

Skin metastases from transitional cell bladder cancer.

Three cases of transitional cell bladder cancer metastatic to skin are described. This manifestation of transitional cell uroepithelial malignancy was previously believed to be quite uncommon. The authors' experience suggests that this occurrence is not that rare and that it may reflect increased longevity in successfully treated patients, allowing previously unusual manifestations of metastatic disease to become evident.

Early-onset cyclophosphamide-induced interstitial pneumonitis.

This article describes three cases of biopsy-proved interstitial pneumonitis secondary to cyclophosphamide therapy. The pulmonary reactions developed after one to three courses of combination chemotherapy in three patients with diffuse histiocytic lymphoma. Resolution of the pulmonary infiltrates and blood gas value abnormalities followed discontinuation of use of this drug without recurrence when chemotherapy regimens excluding cyclophosphamide were subsequently used.

Therapeutic transfusions of previously frozen washed human platelets.

The platelets used in this study were collected by serial centrifugation, and within four hours of collection were frozen with 5% dimethylsulfoxide (DMSO) at an overall rate of 2 to 3 C per minute by storage in a mechanical refrigerator at -80 C. The frozen platelets were stored for four to ten weeks before thawing and washing. After washing, the units were kept at room temperature for six to eight hours before transfusion.

Ultrastructural alterations and phagocytic function of cryopreserved platelets.

Fresh human platelets and platelets cryopreserved in 4% dimethylsulfoxide were examined ultrastructurally before and after incubation in a suspension of latex particles. Cryopreserved platelets had fewer discoid forms than fresh platelets. The cryopreserved platelets had many sphered platelets containing an increased number of vacuoles; the sphered platelets were more electron-lucent margination and pallor of organelles.

Acute myelofibrosis with peripheral myeloblastosis: an acute myeloproliferative disorder.

Acute myelofibrosis is an uncommon fulminant disorder characterized by pancytopenia, premature myeloid elements in the peripheral blood, and bone marrow fibrosis. We report the case of a 59-year-old man who had acute myelofibrosis and peripheral myeloblastosis clinically suggesting the diagnosis of acute granulocytic leukemia. The disease was unresponsive to cytotoxic drugs or androgens and the patient died five months later.

Immunoblastic lymphadenopathy. A report of two cases.

Two patients with immunoblastic lymphadenopathy had lymphadenopathy, hepatosplenomegaly, rash, dysproteinemia, constitutional symptoms, and typical morphologic findings or lymph node obliteration by immunoblasts and plasma cells, proliferation of aborizing vessels, and infiltration with amorphous, eosinophilic material. One patient had massive pulmonary infiltrates that responded to steroid therapy early in the course of the disease, but recurred and were found, at autopsy, to represent immunoblastic invasion of the lung. In both cases, a severe peripheral neuropathy developed during the course of the disease.

Polybrene neutralization as a means of monitoring heparin therapy for extracoporeal cirulation.

Dose-response effects of heparin and protamine in 34 adult patients undergoing cardiac operations were monitored by an in vitro analysis utilizing hexadimetharine bromide (Polybrene) neutralization. Heparin administered prior to cannulation for cardiopulmonary bypass in a dose of 3.0 mg (300 units) per kilogram of body weight, and 1.

Oxygen consumption, platelet aggregation and release reactions in platelets freeze-preserved with dimethylsulfoxide.

Platelets were frozen with 4% or 5% DMSO at an overall rate of 2 to 3 C per minute and were stored at -80 C for as long as 10 months. They were washed with DMSO-plasma and acid-citrate-dextrose (ACD) solutions and were stored in 30 ml of autologous plasma at room temperature for about three hours before transfusion. Measurements were made of oxygen consumption, platelet aggregation and release reaction, platelet factor-3 and-4 activities, and platelet response to hypotonic stress.

Viability and function of platelets frozen at 2 to 3 C per minute with 4 or 5 per cent DMSO and stored at -80 C for 8 months.

Each of 15 healthy male volunteers was treated with 650 mg of aspirin 24 hours before the autologous transfusion of one unit of freeze-preserved platelets. Freeze-thaw-wash recovery values in vitro, viability and function in vivo, and the bleeding time and platelet aggregation response were measured. The platelets were frozen with 4 or 5 per cent dimethylsulfoxide (DMSO) at an overall rate of 2 to 3 C per minute and were stored at -80 C in a mechanical freezer for up to eight months.

Physiologic effects of normal-or low-oxygen-affinity red cells in hypoxic baboons.

Baboons were bled one-third their red cell mass and were given homologous transfusions of red blood cells to restore the red cell volume. One group of baboons received red blood cells with a normal 2,3-diphosphoglycerate 2,3-DPG) level and normal affinity for oxygen, and in this group the 2,3-DPG level after transfusion was normal. The other group received red blood cells with a 160% of normal 2,3-DPG level and decreased affinity for oxygen, and in this group the 2,3-DPG level after transfusion was 125% of normal.

Coagulation changes in baboons during acute experimental hemoglobinemia and dextran infusion.

Evidence of disseminated intravascular coagulation (DIC) was dought in normal baboons infused with autologous hemolyzed whole blood, preceded or followed by infusion of dextran (molecular weight, 70,000). Mean peak plasma hemoglobin following a rapid single injection was 370 mg/100 ml in 2 animals and 1,236 mg/100 ml in 1 animal, while levels during continuous 5 hour infusion in 2 animals averaged 326 and 474 mg/100 ml, respectively. Dextran infusion immediately preceded hemoglobin injection in 2 baboons and followed hemoglobin injection by 1 1/2 and 2 1/2 hours, respectively, in 2 baboons.

Effect of hemoglobin and hematin on plasma clearance of hemopexin, photo-inactivated hemopexin and albumin (38575).

The plasma half clearance time (T1/2) of isotope-labeled rabbit hemopexin was 35.5 plus or minus 1.9 hr in rabbits.

Coagulation studies during experimental hemoglobinemia in humans.

Infusion of autologous hemolyzed blood in humans has served as a model for various experimental investigations for many years. Numerous studies have shown this model to be unattended by any adverse clinical reactions. In this study evidence of subclinical disseminated intravascular coagulation (DIC) was sought in normal humans infused with autologous hemolyzed blood.