Biomedical subjects
Publications and source records attributed to H Lurie.
A 78-year-old woman had a conjunctival mass in the inferior fornix. The lesion was diagnosed as a solitary relapse of Hodgkin's disease (HD), lymphocytic predominance type, which had been diagnosed 6 years earlier as stage III-B. It was successfully treated by local irradiation, with no evidence of local recurrence or any local ocular complications during a follow-up period of 3 years.
A preclinical study of intracavitary lymphocytes (ICL) from malignant effusions of cancer patients is described. The object of this study was to evaluate the antitumor potential of ICL as a baseline for developing adoptive immunotherapy trial for ovarian carcinoma patients. The main parameters studied were functional cytolytic activity of fresh and recombinant interleukin-2 (rIL-2)-activated ICL and their phenotypic characteristics. Spontaneous cytolytic activity of ICL was detected in all samples tested against natural killer (NK)-sensitive targets (K562), while very low activity was shown against NK-resistant targets (Daudi) and fresh tumor cells. Activation in culture with rIL-2 generated cytolytic activity against NK-resistant targets and significantly augmented NK activity. The pattern of antitumor lytic activity of ICL resembles lymphokine-activated killer cell activity and is non-major histocompatibility complex restricted against a variety of tumor targets. Phenotypic characterization of fresh ICL showed the predominance of CD3+ cells with the CD4/CD8 ratio resembling that of peripheral blood lymphocytes. During culture with rIL-2, changes in phenotypic expression of activated ICL were detected: enrichment in NKH1+ cells (up to 65%), of CD8+ (up to 70%), and very late antigen (VLA)-1+ cells (up to 54%), concomitantly with a decrease in CD4+ population. The NKH1, CD8, and VLA-1 expression peaked at 2 weeks in culture and coincided with peak cytolytic activity of cultured ICL. Depletion of CD8+ cells from activated ICL resulted in a decreased proportion of cells expressing the NKH1 and VLA-1 phenotype, whereas depletion CD4+ cells led to enrichment in CD8, NKH1, and VLA-1 antigens. Cytolytic activity was significantly increased in CD4 depleted population against NK-resistant and NK-sensitive targets. In this study we found that rIL-2 activation and culture of ICL generates killer activity against NK-resistant and fresh tumor targets and that enrichment in expression of NKH1, CD8, and VLA-1 antigens is associated with effector function.
Early results of a prospective, randomized trial of active, specific immunotherapy adjunctive to nephrectomy in all stages of RCC are presented. Forty-three patients with median followup of 30 m, who were randomly allocated to either immuno-hormonotherapy arm (IMT), or hormonotherapy alone (HT), are evaluated in terms of progression-free interval (PFI) and overall survival by life table method. Immunotherapy consisted of autologous irradiated tumor cells (AITC), admixed with bacillus Calmette-Guérin (Glaxo) administered by the intradermal and endolymphatic route. Clinical results of this study show only a trend for advantage of the experimental (IMT) arm over the control (HT) arm, this trend did not reach statistical significance level: prolongation of disease free period in stages I-III with localized disease (p less than 0.1) and prolongation of survival in patients with metastatic disease (p less than 0.07). A correlation was established between induction of cutaneous delayed hypersensitivity (DTH) to AITC and prolonged PFI and survival: patients with positive DTH had a significantly better course of disease than those who could not be converted to positivity after repeated immunizations. Positive in vitro leukocyte migration inhibition against autologous tumor preparations correlates well with positive in vivo cutaneous DTH. Some immunological aspects of active immunization with autologous tumor cells are discussed.
Explore the source record for details and available documents.
The influence of combined chemotherapy (cyclophosphamide, 25 mg/kg) and local tumor hyperthermia (42.5 degrees C for 30 minutes) followed by amputation was studied on a metastatic tumor model (Lewis lung carcinoma) injected into the footpad of BDF1 mice. The tumor was found to be sensitive to heat treatment. Neither local tumor heating nor chemotherapy improved life span when "singly" combined with later surgery. However, combined chemotherapy and local tumor heating followed by later surgical removal of residual tumor did show a significant improvement of survival (P less than 0.01). Possible explanations are commented on.
A sandwich technique of adjuvant radiotherapy was used to treat 47 patients with rectal cancer. Preoperatively, 3000 rads were given for 12 days; 300 rads per day for five days, with a two-day interruption and another five days of 300 rads per day, followed by surgery ten days later. On the basis of the histopathologic findings, 26 patients with Dukes' B2 and C rectal cancer were given 3000 rads postoperatively in the same manner as the preoperative irradiation, starting four weeks after surgery. Patients with Dukes' A and B tumors received no postoperative irradiation. The preoperative radiotherapy was well tolerated by all patients with only minimal side effects. During surgery there was no technical difficulty in removing the tumor en bloc and, in some cases, the macroscopic impression was that the tumor had actually disappeared. In most cases, microscopic examination revealed fibrotic tissue replacing the tumor. In some cases, no cancer tissues were observed. The postoperative course was uneventful, the average length of hospitalization being 14.5 days. We believe that this technique of adjuvant radiotherapy with a moderate dose of irradiation is a logical and well-tolerated approach in the treatment of rectal cancer, and patients who were inoperable before irradiation became resectable after it.
The combined effect of cis-platinum cyclophosphamide, and local hyperthermia was investigated in mice bearing the metastatic Lewis lung carcinoma. The combined action of cyclophosphamide and cis-platinum resulted in an additive effect. The triple combination of cis-platinum, cyclophosphamide and local hyperthermia revealed thermal potentiation of the combined drug-induced growth delay.
Forty-nine patients with localized carcinoma of the prostate were treated by external radiotherapy together with hormonal manipulation and were followed up to six years. Hormonal manipulation included bilateral orchiectomy and diethylstilbestrol, 3 mg/day. The cumulative five-year survival for the 49 patients was 87.6%, with 11% progression rate to stage D during that period. In 40 patients (81.6%), a decrease in the size of the prostate was noted. In none of the patients was there local recurrence of the tumor during the period of follow-up. Transient gastrointestinal and/or urinary symptoms occurred following radiotherapy in 11 patients (22.4%), and in four patients severe cystitis or proctitis appeared. Complications related to hormonal therapy occurred in 11 patients (22.4%). The high survival rates reported herein, together with the low progression rate to stage D during six years of follow-up, may justify the early institution of radiotherapy in combination with hormonal manipulation for patients with localized carcinoma of the prostate. A randomized study with an extended number of patients is underway to further evaluate this mode of therapy.
Twenty-four patients with confirmed Stage D carcinoma of the prostate were treated with a combination of bilateral orchiectomy, estrogens (diethylstilbestrol) and chemotherapy (5-fluorouracil), and cyclophosphamide soon after diagnosis was established. Patients were followed up between forty-two to seventy-two months. Seventy-five per cent of patients reported relief of bone pain after initiation of therapy, and 83.3 per cent reported relief of their urinary symptoms. The primary tumor shrank in all patients, and initial stabilization or partial disappearance of osteoblastic lesions on bone scans was noted in 79.1 per cent of patients. The cumulative survival rates at five and six years were 63.48 and 50.78 per cent, respectively. The combined therapy was well tolerated by the patients, and complications were not severe and of a transient nature.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 53-year-old woman who had severe rectal bleeding was found to have a perirectal hemangioma as a source of the bleeding. Four years prior to this admission, she had undergone, in another hospital, hemorrhoidectomy, which had required resuturing several times in order to stop rebleeding. The diagnosis of hemangioma was established after extensive roentgenographic examination. The patient was treated with low-dose irradiation, divided into five consecutive sessions, to the affected area. The bleeding stopped, and the patient has been free of disease since treatment two years ago. The lumen of the rectum is not narrowed, the mucosa appears normal, and the elasticity of the rectal wall has been preserved.