Search

With the introduction of monoclonal antibodies in immunohistochemistry and im-munocytology the detection of single disseminated tumor cells became achievable. In breast cancer as well as in gastric, c

Individual disseminated epithelial tumour cells were detected in bone marrow aspirates in 41 of 108 patients (37%) with squamous cell cancer of the head and neck region by an immunocytochemical technique based on monoclonal antibodies raised against the cytokeratin No. 19. In the clinical stage I (T1N0M0) tumour cells were detected only in 26.3% of the patients, whereas in stage IV (T4N0M0, T(all)N2-3M0, T(all)N(all)M1) almost twice as many patients (47.7%) presented with tumour cells in the bone marrow. Apparently, grade of differentiation of the tumour (grading) had no influence on the spread of single tumour cells. An influence of the different localisations of the primary tumour on tumour cell spread or the rate of tumour recurrence cannot as yet be discovered. Cytokeratin No. 19 expressing cells were not detectable in the bone marrow of 18 patients with non-malignant disease. Seventy-three patients were included in a follow-up study with a mean observation time of 25 months (range: 4-52 months). The presence of epithelial cells at the time of primary treatment appears to indicate a significantly higher risk of development of local or distant tumour recurrences (p = 0.01). Of 46 patients initially exhibiting no tumour cells in the bone marrow, only 14 had a clinical recurrence. Whereas 17 of 27 patients who presented with tumour cells in the bone marrow developed either a local tumour recurrence or distant metastases in different organs. Patients presenting with bone marrow tumour cells showed a significantly shorter disease-free survival than those without (p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)

Background: In advanced renal cell cancer (RCC) interleukin-2 (IL-2) and interferon-α (IFN-α) have shown modest clinical activity as single agents, substantial toxicity being associated with IL-2. For

The pathophysiological mechanisms involved in the development of a spontaneous systemic capillary leak syndrome (CLS) are unknown. In contrast, CLS is a well-known side effect of high-dose interleukin-2 (IL-2) therapy in solid tumors. We report on a patient who developed CLS with high serum levels of endogenous IL-2 under immunosuppressive therapy for chronic graft-versus-host disease (GvHD) after allogeneic bone marrow transplantation (BMT). Generalized edema persisted for 10 weeks. The condition resolved after antibiotic therapy of a septic shock with beta hemolyzing streptococci group A. Thus, a latent infection may alter cytokine homeostasis and may cause CLS in BMT patients.

Metastasis is the principal event leading to death in cancer patients. However, expression of diagnostic and therapeutic molecules is determined in primary tumors, although they are often completely resectable. Therefore, the present study immunohistochemically compared the expression profile of various prognostic molecules in primary gastric tumors (n = 35) and their synchronous metastases (regional lymph nodes, n = 32, liver, n = 10, peritoneum, n = 17). Lewis X and ICAM-1 revealed a similar expression pattern in primary and metastatic lesions. Contrary, in comparison to the primary cancers, CD44 expression was upregulated in the metastatic tumors independently of their localisation (p = 0.009). E-cadherin and LFA-3 expression were preferentially increased in distant metastases, but not in locally advanced gastric tumors (liver: E-cadherin, p = 0.001; liver and peritoneum: LFA-3, p = 0.0067). These data suggest the consideration of the metastatic protein profile for the selection of cancer patients in new molecular therapeutic strategies.

The present prospective study evaluates the impact of disseminated tumor cells in bone marrow of breast cancer patients on overall survival. In the whole patient cohort consisting of 1045 stage I – III patients the lymph node status was demonstrated to be the strongest independent prognostic factor, whilst no relevant impact of the bone marrow status could be demonstrated. Evaluating the node-negative (n = 596) and the node-positive patient (n = 439) cohorts separately revealed that the bone marrow status is an independent predictor for poor survival in node-positive patients (RR 1.59; CI 1.07 – 2.37; median follow up of 53 months).

PURPOSE In 1997, the immunocytologic detection of isolated tumor cells in bone marrow, termed micrometastasis, will be optionally included in the tumor-node-metastasis (TNM) classification indicated M1(i). In the present meta-analyses, 20 studies, which included 2,494 patients, regarding the prognostic influence of a positive bone marrow micrometastases (BMM) status on relapse-free and/or overall survival were analyzed. MATERIALS AND METHODS The literature search included the Medline and Current Contents bibliographic data bases from August 1980 to June 1997. The statistical evaluation considered the prognostic influence of the prevalence of micrometastatic cells in bone marrow on relapse-free and/or overall survival. The comparable effect estimate and its corresponding 95% confidence interval (CI) were calculated with the Mantel-Haenszel method using the originally published data of the retrieved studies. RESULTS The presence of epithelial cells in bone marrow was detectable in all carcinoma types, with a median prevalence of approximately 35%. Fourteen of 20 studies found a positive correlation between positive BMM status and reduced relapse-free survival by univariate analysis, but only five of 11 studies confirmed positive BMM status as an independent predictor of short disease-free survival. Regarding overall survival, positive BMM status was identified univariately in five of 12 studies, but multivariately in only two studies, as an independent factor of poor survival. Despite the heterogeneity of the studies, calculation of the relative risk (RR) for reduced relapse-free survival was possible for breast cancer, which resulted in a Mantel-Haenszel RR (RR(MH)) of 1.34 (95% CI, 1.27 to 1.42). CONCLUSION In conclusion, the results suggest that the prognostic impact of epithelial cells in bone marrow remains to be substantiated by further studies using standardized methodic protocols before its entrance in the TNM classification.

Seventy-eight transfusions of autologous platelets were given to eight alloimmunized patients receiving curative chemotherapy for acute leukemia. Platelets were collected at regeneration of hematopoiesis after a chemotherapy cycle, cryopreserved with 5% dimethylsulfoxide in liquid nitrogen, and retransfused during bone marrow aplasia following the next treatment cycle. The in vitro platelet recovery after freezing, thawing, and washing was 85 +/- 4%. The in vivo corrected count increment 1 h after autologous platelet transfusions was 11 +/- 5 x 10(9)/l. With the exception of moderate urticaria and slight nausea each after one transfusion, no immediate or chronic side effects occurred. The bleeding time was shortened and hemorrhage during bone marrow aplasia was prevented in all alloimmunized patients by autologous platelet transfusions.

Due to their specificity, constant properties and virtually unlimited supply monoclonal antibodies have given an important stimulus to almost every field of biomedical research within the last 10 years. The generation of mouse monoclonal antibodies includes immunisation of mice followed by fusion of mice spleen cells with a murine myeloma cell line. With this procedure hybridomas secreting monoclonal antibodies of a predefined specificity can be obtained. For three major reasons we worked on the establishment of human hybridomas secreting specific antibodies: human antibodies are less immunogenic when used for diagnostic or therapeutic purposes, only human monoclonal antibodies allow the analyses of the human B cell repertoire, there is evidence that human monoclonal antibodies recognise epitopes different from those seen by murine monoclonal antibodies. Therefore, we set out to generate human B cell hybridomas by cell fusion using the human lymphoblastoid B cell line Wi-L2-729 HF2 and lymphocytes from melanoma patients. The lymphocytes were isolated from tumour-draining cervical lymph nodes, stimulated with pokeweed mitogens plus the autologous tumour cells in an enriched tissue culture medium and fused in the presence of polyethylene glycol. Supernatants of hybridomas were screened in a single cell immunosorbent assay with either autologous melanoma cells or established melanoma cell lines fixed to the bottom of Terasaki plates or on cytospin preparations of these cells using the immunoperoxidase staining procedure. We could demonstrate that the tumour draining lymph nodes of these melanoma patients contained B lymphocytes capable of producing antibodies reacting with the tumour cells.(ABSTRACT TRUNCATED AT 250 WORDS)