Similar lymphocytes in Hodgkin's disease and breast cancer?
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Biomedical subjects
Publications and source records attributed to S E Order.
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Between 1971 and 1975, 55 patients underwent palliative radiation therapy for symptomatic hepatic metastasis. Most patients received 2400 rad in 300 rad fractions to the entire liver. There were 31 patients who received concomitant chemotherapy, and 14 who were prior chemotherapy failures. Ninety percent of the patients with symptomatic pain and liver enlargement and significant palliation of their symptoms. The median survival of the entire group was 4.5 months, while those patients experiencing an excellent response (21) had a median survival of 9 months. The median survival of patients having an excellent response to radiation is comparable to that of patients having regional arterial chemotherapy while incuring fewer complications. The overall complication rate of those patients completing therapy (50) was 12%.
Between July 1968 and December 1974, 53 patients with lung cancer were planned for preoperative irradiation and surgery. All patients were considered clinically marginally resectable because of advanced local disease, 4 Stage II patients, with limited pulmonary reserve and 49 Stage III patients. Most patients received 3000 to 4000 rad followed in two weeks by thoracotomy. Forty-six patients were explored and 38 were resectable. Twelve patients are alive with a median follow-up of 48 months. The cumulative 5-year survival of all resectable patients is 27%. The survival of patients with marginally resectable lung cancer treated by accelerated radiotherapy followed by aggressive surgery approaches the survival experience of patients with primary resectable lung cancer and is superior to such patients treated with radiation therapy alone.
The lymphocytotoxic effect of therapeutic irradiation may lead to immune depression. The significance of such effects is yet to be determined in many malignancies, especially in light of the persistant immune depression in many "cured" patients. The present review examines the effects of age, type of cancer, and stage of disease as well as the results of immune parameters following radiation therapy. Factors to be considered in both the analysis of present day data and in future studies are also reviewed.
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The early demonstration of immunologic specificity of antibodies and the discovery of tumor antigenic specificity are reviewed in the light of experimental and clinical attempts to use such reagents in the management of cancer. Recent results in regard to tumor antigens and radiolabeled antibody preparations are shown to be practical for experimental diagnosis and therapy and potentially for similar clinical purposes.
Iodine-131-labeled immunospecific gamma globulin derived from immunization of rabbits with F antigen, a tumor associated antogen in Hodgkin's disease, has been utilized for intralymphatic infusion in a patient with known recurrent Hodgkin's disease inthe inguinofemoral and pelvic regions. Rectilinear scanning successfully delineatedthe tumor masses, and external monitoring showed retention of activity in the tumor sitesover an 8-day period.
Soluble protein extracts of non-Hodgkin's lymphomata are fractionated by Sepharose chromatography. Each protein segregate is tested as a target antigen in immunoelectrophoresis using antiserum prepared by immunization with each fraction and an F and S antiserum of Hodgkin's tumour. F and S antigens are prominent in a histiocytic lymphoma with lymphoid infiltrate and Hodgkin's disease. A monospecific F antiserum is used to determine the stromal distribution of the antigen by immunofluorescence in tumour infiltrates and also to demonstrate F antigen activity in the medulla of the adolescent thymus. Implications of these findings are discussed and a general plan for analysis of the lymphomata outlined.
A murine tumor-associated alpha-globulin was identified by immunofluorescence, cytotoxicity, and immunoelectrophoresis. The antiserum resulting from heterologous immunization with the segregated antigen was tolerated in multiple injections and was therapeutic; host cell participation by macrophages and lymphocytes led to the therapeutic result. Investigation of human ovarian carcinoma demonstrated an alpha-globulin which shares antigenic specificity with other tumor-associated antigens. The successful scanning of a tumor mass with a heterologous antibody directed against a tumor-associated antigen demonstrated the feasibility of applying these techniques to clinical cancer.
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Antigens which exist in high frequency in tumor tissues of patients with Hodgkin's disease have been obtained in relatively concentrated form by gel chromatography procedures. Further purification and analysis of these antigens performed in the present study have demonstrated that the antigen of fast electrophoretic mobility (F-antigen) is normal tissue ferritin. The identification of F-antigen as ferritin has been made on the basis of comparative physicochemical and immunological analyses of purified F-antigen and normal ferritin. Thus, F-antigen was found to contain iron and to be similar to ferritin in molecular weight, amino-acid composition, electrophoretic mobility, isoelectric distribution, and immunological reactivity. Absorption of a monospecific heterologous anti-F antiserum with normal tissue ferritin completely removed all anti-F antibody activity. Moreover, the absorption of polyspecific heterologous antiserum to crude Hodgkin's extracts, which contains antibodies reacting with F-antigen, the slower migrating S-antigen, and a third specificity present in lysates of normal peripheral blood lymphocytes (PL-antigen), with ferritin, removed only anti-F activity, thus distinguishing the S- and PL-antigens from ferritin. The existence of ferritin in high quantities in serum of Hodgkin's disease patients may provide a tool of potential diagnostic and prognostic importance in the management of this disease.
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Two antigens that exist in high frequency in tumor tissues of patients with Hodgkin's disease have been obtained in relatively concentrated form. Extracts of Hodgkin's spleen tumor tissue, when subjected to chromatography on Sephadex G-200, separate into three major protein peaks of which only the first (peak I) possesses the predominant antigenic activities associated with the disease. Antigenic analysis performed with hyperimmune rabbit antisera obtained after repeated immunizations with peak I proteins demonstrated that this fraction contained both F and S antigens associated with Hodgkin's disease and small contaminant amounts of an antigen associated with normal lymphocytes. The tissue distribution patterns of the Hodgkin's disease tumor-associated antigens suggest that they both originate in lymphoid tissues and that the F antigen may represent a product of reactive lymphocytes while the S antigen may be a dedifferentiation antigen expressed in very immature lymphocytes.
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