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Biomedical subjects

G M Mavligit

Publications and source records attributed to G M Mavligit.

At least 73 records · Page 4Linked to original sources

Reversible elevation of plasma CEA associated with iatrogenic unilateral hydronephrosis in a patient operated for colorectal cancer.

A patient is reported with progressively rising plasma levels of CEA in association with iatrogenic, unilateral hydronephrosis, subsequent to surgery for colorectal cancer. The CEA level returned to normal with spontaneous recovery of the hydronephrosis. The knowledge of this association should serve as an additional guideline when a "second-look" operation is being considered in colorectal cancer patients (who have been previously rendered free of disease by pelvic surgery) when plasma CEA begins to rise progressively.

Carcinoembryonic Antigen↗

Sequential chemoimmunotherapy of colorectal cancer: evaluation of methotrexate, Baker's Antifol and levamisole.

Fifty-two untreated patients with colorectal cancer were randomized to receive 5-fluorouracil (5-FU) alternating either with methotrexate (MTX) or Baker's Antifol (BAF) with or without the immunostimulant, levamisole (Program I). Fifty-five patients who had received prior treatment were randomized to receive methyl-CCNU (Me) with MTX or BAF (Program II). Fifteen of these patients had failed to respond to initial therapy with 5-FU plus MTX or BAF and subsequently received Me plus the alternate antifol. Overall response rate for each of programs I and II was 10%. The responses were 1/11 with 5-FU-MTX plus levamisole, 2/12 with 5-FU-MTX, 1/8 with 5-FU-BAF plus levamisole, 0/8 with 5-FU-BAF, 2/20 with Me-MTX and 2/21 with Me-BAF. The median survival times (MST) for patients receiving Programs I and II were 10 and 5 months, respectively. The MST for all patients receiving MTX was significantly longer than that of patients receiving BAF Survival was not influenced by levamisole administration. Both chemotherapy programs were well tolerated. The sequential administration of 4 active agents failed to improve the results of treatment of colorectal cancer.

Adolescent↗

In vitro antitumor reactivity of mononuclear leukocytes from cancer patients receiving immunotherapy with BCG.

Mononuclear cell-mediated cytotoxicity (MCMC) against cultured tumor target cells was studied sequentially in melanoma and breast cancer patients before and during BGC administration. MCMC showed temporary fluctuations. In patients with locally advanced melanoma and carcinoma of the breast after tumor load reduction, the administration of BCG may increase the MCMC. This did not always correlate with a favorable clinical course. Potentiating serum factors appeared in 50% of these patients during BCG therapy, while blocking factors were rare. Neither correlated with prognosis. In patients with disseminated melanoma receiving chemoimmunotherapy, increases in MCMC may be related to clinical course. Blocking serum factors frequently developed in this group of patients and potentiating factors were rare. Neither correlated with the clinical course. Significant MCMC among normal donors and the apparent lack of specificity suggest a common nonspecific (? natural) cellular reactivity against cultured tumor target cells.

BCG Vaccine↗

Chemotherapy and chemoimmunotherapy of colorectal cancer. Role of the carcinoembryonic antigen.

The current status of treatment for patients with colorectal cancer is suboptimal. Although approximately 80% of patients are amenable to surgery, cure is only possible for 40%. Survival of patients is closely related to disease staging at the time of surgery, being poorer for patients presenting with locally advanced disease or with distant metastases. Patients who undergo curative resections and are categorized as having a high risk of developing recurrence, such as those with regionally involved lymph nodes, should be subjected to studies of adjuvant therapy. Although the definite role of such studies is still under evaluation, there already exist studies of chemotherapy with 5FU, chemoimmunotherapy with 5FU-BCG, and radiation therapy, suggesting the beneficial effect of these treatment modalities based on prolongation of the disease-free interval and survival of patients. The status of available treatments for patients with advanced disease is poor. There exists no single or multidrug regimen capable of producing significant tumor regression to improve the patient's quality of life and survival. Accordingly, the active clinical investigation of newer and potentially effective chemotherapeutic agents should continue. The role of present immunotherapy is not fully determined, although several studies suggest its potential usefulness in the adjuvant and the advanced situations. Serial determinations of CEA are extremely helpful in the postsurgical monitoring of patients receiving adjuvant treatments and also in the follow-up of patients undergoing therapy for overt metastatic disease.

Antineoplastic Agents↗

Suppressor cell activity in cancer patients: a possible role for thymic hormones.

We have identified the presence of suppressor cell activity in the peripheral blood of immunosuppressed stage IV cancer patients. The patients' cells had a diminished mitogenic response to phytohemagglutinin (PHA) and suppressed the PHA mitogenic response of a normal donor's peripheral blood lymphocytes (PBL). Thus, PBL from a cancer patient whose PHA mitogenic response was 3932 counts per minute (cpm), cultured together with a normal donor's PBL with a PHA mitogenic response of 82,865 net cpm, caused a greater than 50% reduction in the latter (37,651 net cpm). Suppressor cell activity was present in 12 of 14 patients tested. This effect was partially mitigated by irradiation with 4000 rads in nine of 14 patients. Preincubation of the patients' cells with thymosin followed by the addition of thymosin to the co-cultured cells mitigated the suppressor activity in five of ten patients and thymic humoral factor did the same in four of 11 patients. A radiosensitive and thymic hormone-responsive suppressor cell may be present in the peripheral blood of cancer patients. Confirmation of this preliminary observation and further characterization of the cell or cells is currently being undertaken.

Female↗

Prognostic significance of vascular invasion in colorectal cancer of Dukes' B class.

To further characterize important prognostic factors in colorectal cancer of the Dukes' B class the pathologic material from 143 Dukes' B patients was reviewed for the presence of lymphatic and/or blood vessel invasion and correlated with the postoperative tumor-free interval and overall length of survival. In 27 patients with vascular invasion within the bowel wall, both the tumor-free interval and the overall survival time were not significantly different from the same parameters in 116 patients without vascular invasion (P = 0.28, P = 0.12 respectively). These data suggest that vascular invasion within the bowel wall per se is not an important prognostic factor among patients with colorectal cancer of the Dukes' B class.

Blood Vessels↗

Histiocytic lymphoma in the brain as the only manifestation of relapse following remission maintainance with BCG immunotherapy.

This report describes an unusual case of lymphoma which, after 54 months of complete remission induced with chemotherapy and maintained with BCG immunotherapy, relapsed in the brain alone. It is possible that the immunotherapy led to this pattern of relapse: this is supported by several other studies. The difficulty in diagnosing brain lymphoma is emphasized.

BCG Vaccine↗

Adjuvant immunotherapy and chemoimmunotherapy in colorectal cancer (Dukes' class C): prolongation of disease-free interval and survival.

The poor postsurgical prognosis in patients with colorectal cancer of the Dukes' C classification has prompted a clinical trial of adjuvant immunotherapy versus chemoimmunotherapy intended to prolong either the disease-free interval or the overall survival or both. One hundred and twenty-one patients have been entered on this study. Fifty-two patients received BCG alone and 69 patients received the combination of 5-FU and BCG. The disease-free interval and the overall survival were compared with similar parameters in a group of historical controls with similar prognostic characteristics who were operated on in our institution prior to the initiation of the current study. There was no difference as yet between BCG alone and the combination of 5-FU + BCG in terms of both the disease-free interval and the survival. Both treatments, however, had significantly better results than the surgical controls. Adjuvant therapy, especially with BCG is advocated for patients with colorectal carcinoma, Dukes' C class, following potentially curative surgery.

BCG Vaccine↗

Chemoimmunotherapy of metastatic large bowel cancer: nonspecific stimulation with BCG and levamisole.

The administration of two chemoimmunotherapy programs to 103 consecutive patients with metastatic colorectal cancer resulted in improved survival for patients who achieved either objective tumor regressions or disease stabilization for more than 8 weeks. Objective tumor regression was observed in 47% of patients treated with the Ftorafur-methyl-CCNU-methotrexate-Bacillus Calmette-Guerin (FTOR-MeM-BCG) program and in 34% of patients treated with the 5-fluorouracil-methotrexate-Baker's antifol (FU-M-BAF) +/- Levamisole program. The combinated median duration of survival for patients who achieved objective tumor regression and disease stabilization with FTOR-MeM-BCG was 13 months compared with 6 months for patients who had progression of disease (p = 0.001). The corresponding values for patients treated with FU-M-BAF +/- levamisole were 11 months and seven months, respectively (p = 0.001). While the role of BCG immunotherapy in these results remains speculative, the administration of levamisole immunotherapy did not appear to have influenced results significantly. Patients who presented at diagnosis with Dukes A, B and C lesions, and therefore had longer disease-free intervals, responded more frequently to chemoimmunotherapy and survived longer than patients who presented at diagnosis with Dukes D lesions. Similarly, greater antitumor effect was observed in patients with lower pretreatment plasma CEA levels evaluation of these pretreatment characteristics may have insignificant implications for the design of future clinical trials.

BCG Vaccine↗