[Current status of immunotherapy of malignant tumors].
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Biomedical subjects
Publications and source records attributed to M Betzler.
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The possibility of differentiating estrogen-sensitive human breast cancer using incorporation studies with labeled uridine as a precursor of RNA metabolism is described. The purpose of this study was to explore inadequate function of the estrogen receptor as an alternative or supplementary aid in selecting patients for hormonal manipulation. The disadvantage of the test is that only hormone dependence of a proliferating tumor cell population can be evaluated. Highly differentiated breast cancer cells exhibit the greatest estrogen sensitivity. The hormone-dependent tumors of premenopausal women show an increase in RNA synthesis, whereas uridine incorporation appeared to be inhibited in postmenopausal women.
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Serum-zinc-levels were evaluated in patients with breast cancer in relation to the various stages. Patients with metastatic breast cancer had significantly depressed zinc-levels, wereas patients with disease apparently localized to the breast and draining lymphnodes had nearly normal serumzinc levels. It appears that the determination of serumzinc in breast cancer patients may be of value in discriminating between localized and metastatic disease.
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Adjuvant chemotherapy allows a study of the effects of cytotoxic drugs on natural human haematopoiesis. We describe serial studies of granulopoiesis performed during and after intermittent adjuvant chemotherapy for breast cancer (adriamycin plus cyclophosphamide, given for six courses at monthly intervals). After drug administration, a sequential wave of depletion and regeneration through successive granulopoietic compartments was observed. With repeated chemotherapy, moderate neutropenia developed, and the blood CFU-C pool size became progressively reduced. After the sixth chemotherapeutic course, granulopoietic regeneration was delayed. Following discontinuation of chemotherapy, a long-lasting (greater than 200 d) reduction of the blood CFU-C pool size, together with neutropenia and reduction of marrow segmented neutrophils, was observed, suggesting a defect of granulopoiesis with persistent granulopoietic hypoplasia. In patients with expected long survival, residual bone marrow damage should be added to the list of potential late side effects of cytotoxic drug therapy.
The distribution of lymphatic subpopulations in the peripheral blood of patients with malignant solid tumors has been studied in two steps. Firstly, it was investigated whether there are changes in the distribution of blood lymphoid cell populations in tumor patients (n = 101) compared to normal individuals (n = 39) and whether there is a correlation between the distribution pattern and the clinical stage of the disease. There was found a significant reduction of T-lymphocytes in patients with cancer, which was marked in the advanced tumor disease (n = 34). In a further step the influence of curative tumor-resection on the lymphatic subpopulations was studied, when 26 operated tumor patients were compared with 23 operated patients without neoplasia. In the group with non-malignant diseases there could not be found a significant pre- and postoperative difference concerning the T- and B-lymphocyte counts. Tumor patients showed after resection of the tumor a significant increase of the absolute and relative number of preoperatively reduced T-lymphocytes. The pathophysiological possibilities for the phenomena of a reversible reduction of T-lymphocytes by the curative resection of the tumor are discussed.
In this study, an attempt was made to describe and evaluate in vitro immune parameters in patients with breast cancer undergoing modified radical mastectomy and adjuvant chemoimmunotherapy. T and B lymphocytes and their in vitro functions were markedly reduced by intermittent combination chemotherapy with adriamycin and cyclophosphamide. Laevamisole was not found to influence immune parameters, neither when given between chemotherapy treatments nor when given after chemotherapy. Lymphocytes expressing Fc receptors and mediating antibody-dependent cell-mediated cytotoxicity were less affected and were even found to be elevated in some patients prior to initiation of therapy. Whether or not antibody-dependent cell-mediated cytotoxicity plays a role in patient defense against tumors remains to be investigated.
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With and without addition of cytostatic agents, incorporation of radiolabeled precursors into the nucleic acid of breast cancer cells was determined in short-term culture. The labeling index, a measure of tumor proliferation, depended largely on cytologic differentiation. Incorporation of radiolabeled precursors in moderately and low differentiated breast cancers was significantly high, whereas only in a part of these tumors was incorporation inhibited by adriamycin and cyclophosphamide. Therefore a group of drug sensitive and metabolic drug resistant tumors could be defined in vitro. Primary resistance against the tested cytostatic agents has been proved in low proliferating and high differentiated breast cancer cells.
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Using the perfusion technique the absorption of glucose, water and sodium was studied in the obstructed bowel. When the obstruction was reversed, the decreased absorption of glucose normalized after 24 hrs., of water and sodium after 36 hrs. The intraluminal pressure does not alter the capillary circulation during obstruction. Histologically an edema of the bowel wall and impaired venous flow was observed. In electronmicroscopic studies no morphological changes could be seen.
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