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Background and Objective: Treatment with oral antineoplastic agents known as tyrosine kinase inhibitors (TKIs) is new and, thus, little is known about their impact on nutritional status (NS), dietary intake, quality of life, and survival. The aim of this study was to provide information on these components in order to guide future nutritional recommendations., Patients and Method: A prospective, observational study in adults who start treatment with TKIs, in whom NS was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), anthropometric measures, biochemical parameters, and dietary intake (24-hour dietary recall). The EORTC QLQ-C30 was used to assess quality of life. Nonparametric tests were used in statistical analysis, and survival was analyzed using Kaplan-Meier and log-rank curves., Results: Of the overall sample, 21.7% had moderate malnutrition according to PG-SGA, and 74.2% moderate weight loss at 6 months, but no patient had BMI<18.5kg/m 2 . Patients with moderate malnutrition had lower survival at four years of diagnosis (log-rank=0.015). Energy intake was lower than recommended by the ESPEN 2017 congress, and no patient covered the protein requirements (1.5g protein/kg weight) during follow-up. A worse score on the global health scale of the EORTC QLQ-C30 was related to worse NS., Conclusions: Treatment with TKIs does not appear to have a significant impact on NS and quality of life after 6 months of follow-up. Malnutrition should be prevented through individualized nutritional advice because it is related to shorter survival., (Copyright © 2019 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

High serum levels of vitamin B12 or cobalamin, also called hypervitaminemia B12, is a frequently underestimated biological abnormality. According to the literature, some of the entities related to this finding are solid neoplasia (primary or metastatic) and acute or chronic hematological diseases. Other causes include liver disorders, monoclonal gammapathy of undetermined significance, renal failure and, less frequently, excess of vitamin B12 intake, inflammatory or autoimmune diseases, and transient hematological disorders (neutrophilia and secondary eosinophilia). This article reports on causes of hypervitaminosis B12, our experience and a review of the literature.

Introduction: apart from the known effects of vitamin D on phospho-calcium homeostasis, in recent years there is great interest in its extrabone effects., Objectives: to know the concentration of 25-hydroxyvitamin D (25[OH] D) in newly diagnosed patients of cancer and to verify if there are differences between the different types of cancer., Material and Methods: cross-sectional study of a cohort of recent diagnosed cancer patients who were referred to Endocrinology consultation for a nutritional pre-surgery evaluation. One hundred and thirty-nine medical histories were reviewed. The socio-demographic and biometric data and 25(OH) D concentration were collected., Results: seventy-one of 139 patients had urological cancer, 27 had colorectal cancer (CRC), 35 had head and neck cancer and six, other types of cancer. The mean concentration of 25(OH) D was 50.41 nmol/l (95% CI = 46.67-54.14); 57.97% of patients showed vitamin D deficiency (< 50 nmol/l) and 21.74%, insufficiency (50-75 nmol/l). We found a statistically significant higher prevalence of deficiency (p < 0.01) in head and neck cancer compared to urological cancer: 68.57% and 49.29%, respectively. Year season significantly modifies 25(OH) D concentration (p < 0.01)., Conclusions: there is a high prevalence of vitamin D deficiency among recent diagnosed cancer patients (especially in CRC and head and neck cancer). The use of reference values adjusted by year season could improve the study of 25(OH) D concentrations.

Background: An extremely elevated erythrosedimentation rate (ESR), defined as equal or higher than 100 mm/h, has been linked to serious underlying conditions, such as infections, connective tissue and oncologic disease., Aim: To analyze a group of patients in order to determine the underlying diagnosis and the characteristics associated with extremely elevated ESR in our environment., Methods: Cross-sectional study of adult patients, who presented with at least one ESR equal or higher than 100 mm/h at Hospital Italiano, in Buenos Aires (Buenos Aires, Argentina) between January 2002 and August 2014., Results: During the previously stated period of time, we analyzed the results of 879 patients. All patients were over 18 years of age. The median for the ESR results was 111 mm/h (interquartile range 105-120). The most prevalent etiology of an elevated ESR was infectious (41.64%), followed by malignancies (21.62%) and autoimmune / inflammatory diseases (12.97%). The most frequent individual diagnosis found was pneumonia (11.49%), followed by undetermined causes (5.92%)., Conclusion: When comparing inpatient versus outpatient populations, the most frequent cause was infectious in the former group, while malignancies were the most frequent diagnosis in the latter.

Background and Objective: Improper clinical use of tumor markers (TM) may cause unnecessary additional studies to confirm or refute a positive result. After observing 2 adverse events due to a wrong use of TM, a protocol for improving their use was implemented. The objective of this study was to determine the impact of the implementation of the protocol., Material and Method: This was a pre-postintervention study, where analytical requests of carcinoembryonic antigen, CA15.3, CA19.9 and CA125 were analyzed during one year in patients not undergoing checking of neoplasia. A protocol was implemented and physicians were trained as recommended by the European Group on Tumor Markers, limiting its use to monitor the disease and its treatment. The study period was 2010-2014., Results: The total number of requests dropped 50.81% and the percentage of adequacy of TM increased, each year, from 31.03 to 77.91%., Conclusions: The implementation of a protocol for the proper use of TM contributes to a safer use, avoiding incorrect studies and unnecessary and harmful tests for the patient., (Copyright © 2015 Elsevier España, S.L.U. All rights reserved.)

Preoperative anemia in patients with cancer is highly prevalent, is associated with increased perioperative morbidity and is a risk factor for transfusion. There is evidence that patients who undergo transfusions have higher morbidity, increased cancer recurrence and poorer survival. The pathophysiology of anemia is multifactorial, with an inflammatory component to which chronic blood loss and nutritional deficiencies can be associated. Therefore, preoperative anemia in patients with cancer should be treated appropriately, given that there is sufficient time in the preoperative period. Of the currently available options, parenteral iron is an effective alternative, especially for those types of cancer that have an associated hemorrhagic component., (Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)

Unlabelled: The small number of cases of cancer in children and the difficulties of research, have contributed to there being few studies on the metabolic and nutritional status of these patients. The main objective of this study was to investigate the nutritional and metabolic alterations in children with cancer, and specifically the plasma fatty acid profile after receiving chemotherapy, compared with a group of healthy children., Methods: We selected 12 children with cancer aged between 0 and 16, who had received at least one cycle of chemotherapy, one month before the study and were not end-stage disease. Nutritional survey was conducted, anthropometric measurements, general biochemical analysis and profile of fatty acids in plasma were evaluated., Results: No changes in anthropometric and nutritional biochemical parameters were detected. In the omega-6 fatty acids, lower values of linoleic and docosapentaenoic acid, and higher levels of gamma-linolenic acid, and normal levels of arachidonic acid were observed. In the omega-3, we found normal values of alpha-linolenic acid and docohexanoic acid, and lower values of eicosapentaenoic acid., Conclusion: It seems glimpsed a partial deficiency in the metabolism of polyunsaturated fatty acids in children with cancer, good nutrition and having received at least one cycle of chemotherapy. Further research is needed to allow specific supplementations.

There is a well-known close relationship between cancer and the haemostatic system. Plasma D-dimer (DD) is a marker of fibrin generation and lysis. In the clinical practice, its main use is in the diagnostic algorithms of venous thromboembolism (VTE), and it is one of the diagnostic criteria of disseminated intravacular coagulation. In patients with cancer, the specificity of DD is lower than in the general population, reducing its usefulness. However, there is a growing evidence that points out a possible application of DD in the clinical management of cancer patients as a predictor of VTE, marker of hidden cancer in patients with idiopathic VTE, or even as an independent prognostic factor of response to chemotherapy and survival. In this review, the current evidence supporting the use of DD in cancer patients is critically exposed and discussed., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Objective: To analyse the quality of the prescription of home oxygen therapy (OT) in a health area of Murcia., Methods: A prospective study of 125 patients in a respiratory therapy clinic, evaluated with a questionnaire and blood-gas analysis while breathing ambient air. Related respiratory therapy was also assessedin COPD and asthma patients., Results: We studied 125 cases in the 3 months following the prescription of home oxygen therapy in 72 men (58%) and 53 women (42%) with a mean age of 77.2 ± 11.6. The most common type of home OT prescribed was for palliative cases in 45 patients (36%), followed by COPD in 42 (33.6%). In 88 (92%) of the 96 medical reports that we evaluated, insufficient data as to how to administer oxygen were available. Twenty-five percent of home OT prescriptions were given without blood-gas analyses, and in the 65 cases with a blood-gas analysis only 11 (17%) met oxygen value criteria for home OT as per regulations. Oxygen desaturation was not present in 31% of the palliative care home OT cases. The analysis of blood-gases during the clinic visit in non-palliative care cases demonstrated that 61% did not meet the blood-gas criteria to continue on home OT. Eighty percent of COPD and asthma patients on home OT did not receive the correct respiratory therapy., Conclusions: Quality problems in the prescription of home OT exist in our area. Palliative care is the principal reason for home OT prescriptions. In COPD and asthma patients who receive home OT, related respiratory therapy is not ideal., (Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.)

Background: Hospitalized patients with cancer have a high risk of venous thromboembolism (VTE)., Aim: To study the frequency of VTE and its risk factors in hospitalized patients with cancer., Material and Methods: Retrospective analysis of clinical records of patients with cancer, hospitalized at a university hospital between 2002 and 2004. Patients with the diagnosis of VTE at admission or using anticoagulants, were excluded from the analysis., Results: The medical records of 366 patients were reviewed. Fifty three percent had a digestive cancer, 19% lung cancer, 10% breast cancer and 18% had a tumor of other origin. In 77%, the tumor was in an advanced stage. The most common admission diagnoses were pneumonia, vomiting and dehydration, gastrointestinal bleeding and urinary infection. In 125 patients (34%) pharmacological thrombo-prophylaxis was not used and 242 (66%) received regular or low molecular weight heparin. VTE was detected in 11 patients (3%) and was significantly more common among patients not receiving thrombo prophylaxis compared to those receiving heparin (6.4% and 1.2%, respectively p =0.014). Factors associated to VTE were a history of previous VTE with an odds ratio (OR) of 12.9 (p <0.01), obesity with an OR of 13.3 (p <0.01), recent chemotherapy with an OR of 6.9 (p =0.01). The use of pharmacological thromboprophylaxis had an OR of 0.24 (p =0.05)., Conclusions: Three percent of patients in this series had VTE during the hospitalization. Pharmacological thrombo-prophylaxis significantly reduced the risk of VTE.

Protein analysis in biological fluids has been used for many years for diagnosis and monitoring of diseases. First it was quantification of total protein, afterwards the electrophoretic separation of proteins and later the quantification of specific proteins using immunoassays. These proteins are used as biological markers (biomarkers) of disease. Since a few years, proteomics allows the simultaneous analysis of hundreds of proteins, as well as the analysis of their structural modifications. In this review the current situation of clinical proteomics for the discovery of new biomarkers in biological fluids is presented.

Introduction: Cancer patients can be asymptomatic carriers of the hepatitis B virus (HBV), which can be reactivated by chemotherapy. Our aim was to identify the serological markers of HBV in children with cancer who were asymptomatic carriers of the virus. Fifty two (52) children with cancer treated at the Maracaibo University Hospital in Venezuela were studied, 28 of these children (53.8%) were HBV positive, despite no clinical or biochemical signs or symptoms of hepatitis. The type of serological markers present in each of these children.were investigated. We found 7 cases (25%) with hepatitis B surface antigen (HBsAg) and 2 (7.1%) with anticore as the only markers. Multiple markers were found in the other children: 9 (32.1%) HBsAg and anticore; 7 (25%) HBsAg, e-antigen (HBeAg) and anticore; 3 (10.7%) HBsAg, HBeAg antibody and anticore. In total, of the 28 positive children 20 (71.4%) showed positive anticore and of these 4 (20%) were of the IgM type. Our results show a high level of positivity for HBV in the children with cancer studied. In spite of being asymptomatic carriers of the HBV, it is noticeable the presence of serological markers for acute disease. We recommend testing for HBV serological markers before starting chemotherapy. Should the test results be negative, vaccination is indicated and should they be positive, specialized care is indicated.

The use of recombinant human erythropoietin (r-HuEPO) in cancer patients improves hemoglobin levels and quality of life. This fact, already well known, made oncologists expect a positive outcome in radio and chemotherapy results, as well as in survival. However, new clinical trials show a preliminary evidence of impaired, instead of improved, survival when these agents are prescribed. Erythropoietin (EPO) is becoming a more complex hormone than it was expected. Its non-erythropoietic effects include, among others, angiogenesis and proliferation of certain types of cancer cells. In this work, we review erythropoietin as a natural hormone, as well as the different types of r-HuEPO, focusing on the confusing situation with regard to their use in oncology. We conclude that extreme care must be taken when EPO is prescribed to cancer patients, and we suggest to limit its use to symptomatic anemia, just to achieve moderate hemoglobin levels.

Background and Objective: We aimed to determine the diagnostic alternatives indicated by serum ferritin levels (2000 ng/ml, and to establish the clinical processes associated with very high levels (5000-10 000 ng/ml)., Patients and Method: We retrospectively analyzed cases with serum levels of ferritin serum equal to or greater than 2000 ng/ml between March 2000 and November 2001. Data were obtained from the laboratory's computerized database. Patients' medical records were reviewed by means of a protocol which established the clinical conditions associated with these serum ferritin values., Results: The study involved 135 patients with ferritin levels equal to or greater than 2000 ng/ml. Clinical syndromes included hematological diseases (45.9%), liver diseases (23%), chronic renal failure (17.78%), neoplastic diseases (10.4%), systemic inflammatory diseases (7.4%), chronic transfusions (7.4%), and non-HIV systemic infections (5.9%). Syndromes which are not usually associated with extreme serum ferritin levels were identified in 3.7% of the patients. The highest concentrations were seen in the systemic inflammatory disease group: 5856 (2492) ng/ml. Within this group, four patients with adult onset Still's disease (AOSD) displayed the highest mean ferritin levels: 11 322 (5474) ng/ml., Conclusions: Elevated serum ferritin levels act as a non-specific marker for a large number of disorders. In certain inflammatory diseases such as adult onset Still's disease (AOSD), this finding may be an important tool.

The use of human recombinant erythropoietin (rHuEpo) has been approved by the Food and Drug Administration (FDA) in patients with anemia and cancer. Although good results have been obtained, it is too expensive to permit its use massively. For the purpose of evaluating the therapeutic effect of rHuEpo, including toxicity, predictive response variables and quality of life parameters, a prospective trial was carried out in patients with anemia and cancer. Hematimetric parameters, ferritin, Epo, cytokines, transfusions and quality of life were registered. A total of 36 patients were treated in the protocol (34 were evaluable): 16 men and 20 women, with a medium age 56.4 years; 27 patients were treated with chemotherapy (16 with cisplatinum); 15 patients presented medullar infiltration. In 73.5% patients an increase in the level of hemoglobin was registered, and in 64.7% its normalisation was attained. Transfusional requirements were reduced by 50%. The hemoglobin increase greater than 0.5 g/dl at the second week of treatment was the most significant variable of early response. Patients treated with cisplatinum, seric ferritin lower than 1,100 ng/dl and those without medullar tumoral infiltration responded best. Serum Epo, cytokines (IL-1, IL-6 and TNF) and reticulocyte count at the second week did not correlate with response. Quality of life parameters were better in patients with good response to rHuEpo. It can be concluded that good results in the treatment of patients with anemia and cancer are obtained with rHuEpo.

The value of blind terminal subcultures (7 and 30 days) and prolonged incubation (30 days) of blood cultures from immunosuppressed patients was analyzed in the Fundación Favaloro, the Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia and the Hospital de Niños Ricardo Gutiérrez. A total of 2707 blood cultures and 369 patients were included (transplantation of solid organs 154, oncohematologic disorders 106 and solid tumors 109). Bact-Alert bottles were incubated at 35 degrees C for 30 days in the Bact-Alert System. Bottles with positive signals were routinely removed, and aliquots of the broth were Gram stained and subcultured aerobically in chocolate agar and Sabouraud agar. A total of 136 bacteremic episodes were obtained. The positivization time of blood cultures was 81.6% at 24 h, 93.3% at 48 h, 94.5% at 72 h and 97.7% within 7 days. Only 3 (2.2%) episodes were positive by blind terminal subcultures and 1 (0.75%) by prolonged incubation (14 days). The median time and range of positivization in hours were 13.8 and 2.2-168, respectively. The microorganisms isolated were coagulase negative staphylococci (n = 24), Klebsiella pneumoniae (n = 22), Staphylococcus aureus (n = 21), Escherichia coli (n = 18), Acinetobacter spp (n = 9), Candida spp (n = 8), Pseudomonas aeruginosa (n = 6), Enterobacter cloacae (n = 5), Stenotrophomonas maltophilia (n = 5), Enterococcus faecalis, Salmonella spp and Capnocytophaga sputigena (n = 2), Enterobacter aerogenes, Enterococcus faecium, Citrobacter diversus, Candida albicans, Klebsiella oxytoca, Chryseomonas luteola, Serratia marcescens, Abiotrophia spp, Campylobacter jejuni, Moraxella catarrhalis, Moraxella urethralis, Neisseria sicca, beta hemolytic group G streptococci, Rhodococcus equi, Micrococcus spp, Cryptococcus neoformans and Streptococcus mitis (n = 1). In our experience, blind terminal subcultures and prolonged incubation of blood cultures from immunosuppressed patients are unnecessary and cost expensive.

In a retrospective, descriptive and observational study realized between 1995 and January 1997 the seric levels cholesterol of 610 patients with cancer and 61 healthy ones, who were used as controls were revised. The serum cholesterol observed in the patients with cancer were lower than the ones observed in the healthy controls. These differences show and statistical significance. We could see in our study that cholesterol were lower in patients with disseminate disease than in the ones with localize disease and that had and statistical value. The number of patients included in each type of tumor, the seric cholesterol were lower than the ones obtained in the control group apart from the patients with metastasis in and unknown origin tumor which have not been significant.

We determine the incidence of the malnutrition syndrome and its relation with probable risk factors, in 106 patients, with a mean age of 53.3 +/- 15.4 years, with a diagnosis of cancer confirmed histologically, and who received artificial nutrition either enterally or endovenously, during an average of 16.8 +/- 2 days, which included a supply of 60 to 100 mmol/day of phosphorus. We considered there to be a renutrition syndrome when there as hypophosphatemia; < 2.5 mmol/l, which took place during the nutritional treatment phase, and previous to which, the patients had normal serum levels of phosphorus. The serum electrolyte concentrations were measured prior to the start of the treatment, and daily during the first week, and later every 3 days until the end. The study variables were: age, sex, type of cancer, degree of malnutrition, degree of hypophosphatemia, day on which in occurred, and clinical manifestations associated to this. The relative risk was calculated for the variables of age, sex, malnutrition and cancer. The incidence of the renutrition syndrome was 24.5%; it was more frequent in the enteral group than in the endovenous group (37.5% vs. 18.9%, p < 0.005); and it took place 72 hours after starting the nutritional support, in 61.5% of the cases, with a mean phosphorus concentrations of 1.9 mmol/l; the most frequent clinical manifestations were the neuromuscular ones (30%), and the most frequent type of cancer was lymphoma (15.4%). The risk factors were age greater than 60 years (RR = 1.7), and moderate or severe malnutrition 8RR = 2.0). We conclude that the prevalence of the renutrition syndrome is high in the cancer patients, despite an intense preventive treatment with phosphorus.

Purpose: To analyze the effect of conventional chemotherapy on haematopoietic progenitor cells (HPC) from peripheral blood (PB)., Patients and Methods: The present work studies the behaviour of CFU-GM from PB in 47 patients subjected to conventional chemotherapy with the following diagnoses: non-Hodgkin's lymphoma (NHL): 16; Hodgkin's disease (HD): 8; multiple myeloma (MM): 5; acute leukaemia (AL): 8; solid tumor (ST): 10. A total of 57 studies was performed. As controls, 51 samples of PB from healthy subjects were used. Cultures were made in semisolid medium (methylcellulose), using PHA-LCM as stimulant, evaluating the growth of clusters (cl) and colonies (col) on days 7 and 14., Results: Our findings show that in the overall series of patients the number of clusters from days 7 and 14 and of colonies-7--that is the most differentiated progenitor cells--were decreased with respect to the controls while colonies-14 were slightly increased. When the patients were separated by diagnostic groups, the col-14 were found to be increased in ST (p = 0.03) and in AL; in NHL col-14 were the same as in the controls. In the patients with HD all progenitor cells, including col-14 were much lower than the control values (p = 0.005). In order to determine whether the kind or the amount of chemotherapy received might affect these progenitor cells, we have analyzed the cases of NHL, 11 patients treated with moderate chemotherapy versus 12 patients receiving intensive chemotherapy: a stronger degree of growth in the latter, although with no significant differences. On comparing the cases that had received little previous chemotherapy (< 5 courses) against those who had received more than 5 courses growth was seen to be stronger in the patients who had received the fewest courses (p = 0.04)., Conclusions: These results indicate that the HPC from PB are scanty in certain diseases, such as HD and that in all lymphomas the collection of these cells for transplantation purposes should be performed before they have damaged by an excessive number of chemotherapy courses.

Concomitant resistance of tumor-bearing mice against a second tumor challenge was evaluated in euthymic and athymic mice using 17 tumors with different degrees of immunogenicity. Two temporarily separated peaks of concomitant resistance were detected during tumor development: the first peak was only observed associated with small immunogenic tumors (< 500 m3., it was tumor-specific and mediated by T cell-dependent immunological mechanisms. The second peak was exhibited by large tumors (> 2000 mm3) independently of their immunogenicity; it was non-tumor specific, thymus-independent and correlated with a serum-activity (neither antibodies nor complement) which inhibited the in vitro proliferation of tumor cells. Out of 17 tumors studied, 15 tumors exhibited a moderate or strong concomitant resistance. The remaining two, which exhibited a weak or undetectable concomitant resistance and correlatively, a low or absent serum-inhibitory activity were the only tumors which included lung metastases. This fact suggested a correlation between concomitant resistance, absence of metastases and the existence of an inhibitory factor(s) in the serum. This inhibitory factor was partially characterized: it was resistant to boiling (5-10' at 100 degrees C) and to variations of pH; its molecular weight was estimated between 850 and 1200 D; it was recovered in only one fraction from HPLC (high power liquid chromatography) columns presenting maximum absorption at 215 and 266 nm; amino acid analysis and magnetic nuclear resonance studies suggested the presence of a molecule of thyrosine and one or two molecules of carbohydrates in its structure.

Background: The parathyrine related protein (PTH-RP) is very similar, both in structure and in function, to the PTH and is considered as a mediator in humoral hypercalcemia in cancer. The aim of this study was to know the clinical value of PTH-RP measurement., Methods: Serum PTH-RP concentrations were studied in 22 healthy subjects, 13 patients with primary hyperparathyroidism, 9 patients with solid neoplasms and normocalcemia, 26 patients with solid neoplasms and hypercalcemia and 4 patients with hematologic neoplasms and hypercalcemia. The PTH-RP was quantified by a competitive radioimmunoassay technique using a specific antibody of the PTH-RP 1-40 fragment. Intact parathyrine (i-PTH) was quantified by an IRMA method using 2 polyclonal antibodies (INCSTAR)., Results: Fifteen (68%) of the healthy controls presented undetectable serum PTH-RP concentrations. The serum PTH-RP concentration was normal in all those patients with hyperparathyroidism. Elevated serum PTH-RP values were not found in patients with solid neoplasms and normocalcemia or in those with hematologic neoplasms and hypercalcemia. High values of PTH-RP were observed in 8 out of 9 (88%) of the patients with solid neoplasms and hypercalcemia with bone metastasis and in 7 out of 11 (63%) of the patients with bone involvement., Conclusions: Serum parathyrine-related protein was found to be high in a large proportion of patients with solid neoplasms and hypercalcemia. Serum PTH-RP determination is useful in the clinical investigation of patients with hypercalcemia. Even in patients with bone metastasis, hypercalcemia may have a humoral background.

The rate of HbF was studied in 123 children with different malignancies in order to assess its changes and relationship with other values of peripheral blood. The cases were distributed into 34 with acute lymphoblastic leukaemia (ALL), 19 with acute myelogenous leukaemia (AML), 23 cases of Hodgkin's disease (HD), 16 of non-Hodgkin lymphoma (NHL) and 31 of different solid tumors (ST). ALL and AML groups had the highest HbF rates (2.88 +/- 1.93% and 2.63 +/- 2.7%, respectively), followed by HD and NHL (1.89 +/- 1.09% and 1.81 +/- 1.68%, respectively), whereas the ST group showed the lowest values (1.32 +/- 1.74%). When comparing these figures with the findings in a group of adult leukaemia and lymphoma (1.6 +/- 0,7% and 1.2 +/- 0.5%, respectively), it was found that HbF was increased in the children to a higher extent. The analysis of the gamma G and gamma A chains of HbF, performed on 14 of the patients, showed in 7 cases a correlation similar to the newborn pattern, while this was similar to the adults in the remainders. These findings suggest that some factors intrinsic to the neoplasm might favour, in a different degree, the re-expression of HbF, which, in turn, would not necessarily mean a reversion to the foctal stages since the correlation of the gamma chains was similar to the adult pattern in 50% of the cases studied.

The author makes a review of several biological and clinical aspects of alpha-1-antitrypsin and describes some personal experiments in animals. The values of serum alpha-1-antitripsin are 384.50 +/- 96.25 mg/100 ml in normal individuals, 479.19 +/- 163.76 mg/100 ml in several non-tumoral diseases, and 722.55 +/- 360.99 mg/100 ml in cancer patients. The changes in serum alpha-1-antitrypsin concentration may be useful to distinguish localized tumors (587.45 +/- 251.12 mg/100 ml), invasion of regional lymph nodes (650.9 +/- 280.51 mg/100 ml), and disseminated cancers (848.51 +/- 396.14 mg/100 ml), and to follow tumor evolution. Experiments with the Ehrlich ascites cancer of the mouse carried out by the author show that a correlation exists between tumor mass and serum antitryptic activity.

Employing the agar-gel double immunodiffusion technique, the authors describe the presence of antibodies to a protein fraction existing in the supernatant of Azotobacter chroococcum cultures in a high percentage of blood sera from cancer patients. The small number of false positive results makes them think of the convenience of increasing the sensitivity of the procedure to valorate its usefulness for the early diagnosis of malignant tumors.

The pregnancy specific beta-1-glycoprotein (SP1) was measured by radioimmunoassay in 854 persons (control group 103, non-tumoral diseases 212, germinal tumors 30, and non-germinal tumors 509). Amounts higher than 2.5 ng/ml (upper normal limit) were observed in 35 cases with non tumoral diseases (specially chronic liver diseases), 97 of the non-germinal tumors (specially mammary, respiratory and digestive tumors), and 10 of the germinal tumors (pure and mixed choriocarcinomas, and embryonic carcinoma with yolk sac component). SP1 rarely is higher than 5 ng/ml in non-tumoral diseases and non-germinal tumors, while it is higher than 5 ng/ml in germinal tumors. SP1 is a good marker for trophoblastic neoplasms and shows a correlation with HCG-beta.