D Robinson

Royal Army Medical Corps, Londinium, England, United Kingdom

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Publications (8)34.79 Total impact

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    ABSTRACT: A leukaemic phase is uncommon in large cell lymphoma, particularly at presentation of the disease, and very few cases have been reported since immunological markers became available. We have studied 24 cases presenting over a period of 15 years. 16 were B-lineage and eight T-lineage. In five patients the large cell lymphoma represented a transformation of a preceding low grade, small cell lymphoproliferative disease. Three other patients with T-lineage large cell lymphoma presented with skin infiltration (two cases) or lymphoma-associated nephrotic syndrome (one case) 3-9 months before leukaemia occurred. The other 16 patients (12 B-lineage and four T-lineage) presented with de novo large cell leukaemia/lymphoma. With the exception of skin infiltration, clinical features did not differ between T and B-lineage cases. Prognosis was generally poor although a minority of patients lived 1-2 years. Median survival was 7 months. In the B-cell lymphomas immunological markers were those expected but among the T-cell cases there were many unusual immunophenotypes with frequent failure to express markers which are usually positive in peripheral T cells. Without the availability of immunological markers diagnosis would have been difficult, with acute myeloid leukaemia being the most important differential diagnosis. T-lineage and B-lineage cases could not be distinguished on cytological features. In the majority of cases the cells were very pleomorphic with nuclear lobulation, prominent nucleoli and marked cytoplasmic basophilia being commonly observed. Marked nuclear lobulation was not confined to T-lineage cases but was seen also in seven of 12 cases of de novo B-lineage leukaemia/lymphoma; it was readily apparent in histological sections and on ultrastructural examination.
    British Journal of Haematology 04/1991; 77(3):301-10. · 4.94 Impact Factor
  • D Robinson, P Lackie, V Aber, D Catovsky
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    ABSTRACT: In order to evaluate the ultrastructural features which may be of relevance in distinguishing cells from the various chronic B-cell leukemias, a morphometric analysis was performed on a large number of cells from each disease group. The parameters selected were: cell size, nucleo: cytoplasmic ratio, chromatin condensation, size of the nucleolus and degree of irregularity of both the nucleus and the cytoplasmic outlines. The mean values obtained for each parameter for each disease group were compared statistically. In disorders in which the cells have villous cytoplasmic projections, the quantitative analysis of the cellular features was helpful to characterise the different types of B cells involved. Thus, cells from cases of splenic lymphoma were found to be different from those of hairy cell leukemia, and a variant form of HCL was also identified by its distinct ultrastructural features. Similarly cells from chronic lymphocytic, prolymphocytic leukemia and an intermediate group CLL/PL were identified by the size of the nucleolus and the degree of chromatin condensation. The morphometric findings provided an objective morphological basis for the differential diagnosis between these closely related B-cell leukemias which was further supported by differences in the cells immunophenotype.
    Leukemia Research 02/1989; 13(5):357-65. · 2.76 Impact Factor
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    N Polli, E Matutes, D Robinson, D Catovsky
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    ABSTRACT: The morphological features of normal peripheral blood lymphocytes reactive with three monoclonal antibodies (MoAb) against natural killer (NK) cells, Leu7, OKM1 (CD11b) and Leu11 (CD16) and with two anti-T cell MoAb, CD4 and CD8, have been analysed at ultrastructural level by an indirect immunogold method. Cells having the features of large granular lymphocytes (LGL) but also lymphocytes displaying different morphological characteristics (non LGL; e.g. high nucleo-cytoplasmic ratio and few cytoplasmic organelles) were seen reactive with each of the MoAb investigated. Leu7 identified a higher proportion of LGL (60-80%) than OKM1 (10-95%) and Leu11 (20-48%), and with a stronger binding. A distinct granular structure, recognized as parallel tubular arrays, was more characteristic of the Leu7+, CD8+ LGL and was less frequently seen in the OKM1 and Leu11 positive LGL subpopulation in four out of the five donors investigated. It is of interest that the Leu11 and OKM1 positive subsets, which correspond functionally to cells with greater NK function, had relatively less LGL than the Leu7 positive subsets, raising the issue of the true morphology of NK cells in man. The existence of a minority of CD4 positive LGL was confirmed. Our findings demonstrate that there is a degree of morphological heterogeneity within the normal NK lymphoid population as defined by the membrane phenotype and that certain variability among normal individuals regarding the proportion and structural features of the NK subpopulations may be present.
    Clinical & Experimental Immunology 06/1987; 68(2):331-9. · 3.41 Impact Factor
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    ABSTRACT: An unusual case of prolymphocytic leukemia of the B cell type (B-PLL) in a 79-year-old patient is reported. The clinical and cytomorphological features of the disease were typical of B-PLL, but membrane and cytoplasmic immunoglobulins (Ig) could not be demonstrated by immunofluorescence techniques; 3% to 4% of the cells were shown to have IgG kappa in the cytoplasm by a more sensitive immunoperoxidase method. The cells were unreactive with a panel of monoclonal antibodies against T cell antigens but they were positive with B cell lineage reagents: FMC4, anti-HLA-Dr determinants; FMC7, which reacts with most B-PLL; anti-B1 and anti-B4, which react with most B cell leukemias. Analysis of Ig genes at the DNA level demonstrated that both heavy-chain alleles and one kappa chain allele were rearranged, confirming that the patient's cells were of B lineage. Chromosome analysis revealed a consistent abnormality, t(17;21)(p11;p11), in all cells and, in addition, a 14q+ marker in 10% of the cells. This study highlights the value of DNA analysis techniques for the characterization of neoplastic B cells. The low rate of expression of Ig genes, despite their rearrangement, suggests that a specific transcriptional or posttranscriptional defect must exist in these cells.
    Blood 09/1985; 66(2):391-8. · 9.78 Impact Factor
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    ABSTRACT: We describe a chromosome translocation t(2;13) (p11-12;p11) involving the kappa (kappa) light chain gene region (2p11-12), and a subsequent translocation t(11;22) (q23;11) involving the lambda (lambda) light chain gene region (22q11) within the same clone, in a patient with B-cell prolymphocytic leukaemia (B-PLL), of whose peripheral mononuclear cells 82% expressed (kappa) chains and 8% expressed (lambda) chains. Electron microscope (EM) studies using the immunogold method showed that both kappa- and lambda-producing cells were prolymphocytes. Immunoglobulin (Ig) gene analysis by Southern blotting demonstrated rearrangement of both Ig heavy (H) chain genes and one kappa gene. Although a lambda gene rearrangement corresponding to the minor lambda-positive population was not detected, a small monoclonal (M) band of IgM-lambda was present in the serum. The chromosome translocations and the pattern of light chain expression, particularly the lambda-producing cells, are discussed in the light of the restricted light chain expression observed in Burkitt's lymphomas with variant translocations involving the light chain genes.
    International Journal of Cancer 01/1985; 34(6):769-73. · 6.20 Impact Factor
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    ABSTRACT: We describe a method for electron microscopy that combines myeloperoxidase or acid phosphatase cytochemistry with the labelling of cell surface antigens with monoclonal antibodies and colloidal gold. This technique was tested in samples of normal mononuclear cells, leukaemic T cells with a mature or immature phenotype and an acute myeloid leukaemia. This method allows the demonstration at a single cell level of ultrastructural morphology, cytochemical reaction and the presence of a membrane antigen. It will improve further the analytic power of electron microscopy in the characterization of leukaemic cells particularly in cases of mixed leukaemias and in the study of normal haemopoietic differentiation with monoclonal antibodies.
    British Journal of Haematology 05/1984; 56(4):617-31. · 4.94 Impact Factor
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    ABSTRACT: The ultrastructural and immunologic features of normal convoluted T-lymphocytes were studied with a panel of monoclonal antibodies and the immunogold technique and these were compared with cells from patients with Sézary syndrome (SS) and adult T-cell lymphoma-leukaemia (ATLL). According to the characteristics of the nucleus, two distinct T-cell subtypes, representing 2-4% of normal peripheral blood lymphocytes were recognized: (i) a cerebriform lymphocyte ('Sézary-like') characterized by narrow and deep nuclear indentations, closely resembling the cells of SS, and (ii) a convoluted or polylobated lymphocyte ('ATLL-like'), with shorter and broader nuclear indentations than those seen in SS, that resemble the cells of ATLL. Both types of lymphocytes were positive with the monoclonal antibodies OKT3, OKT4, OKT17 and FMC3 and were negative with OKT8, OKM1 and FMC4 (anti-HLA-Dr) as SS and ATLL cells. A difference was observed with the expression of the anti-T monoclonal antibody 3Al: Sézary-like lymphocytes, like SS and ATLL cells, were 3Al negative whilst ATLL-like lymphocytes were 3Al positive. The close morphological and membrane phenotype similarities observed between these two types of lymphocytes and the cells from SS and ATLL suggest that they may well represent the normal counterparts of the malignant T cells in both conditions.
    Leukemia Research 02/1983; 7(6):787-801. · 2.76 Impact Factor
  • Haematology and blood transfusion 02/1983; 28:131-4.