[Small dose of ARA-C in the treatment of an elderly patient with acute myeloblastic leukemia]

A 79 year old man with a history of myocardial infarction and cerebral infarction was admitted to our hospital in August, 1982. The hematological examination showed anemia and leukopenia (myeloblast 12%), and bone marrow aspiration confirmed the diagnosis of acute myeloblastic leukemia (FAB, M2). Because his general condition was poor, he was treated with small dose of Ara-C (10 mg/m2/12 hr, subcutaneous injections), obtaining complete remission. In cases of acute myeloblastic leukemia in elderly patients where other intensive treatments are contraindicated, it appears to be useful to employ a method of small dose of Ara-C therapy.

[Intrathoracic administration of adriamycin with closed tube thoracostomy drainage for malignant pleuritis: observation on the administration dosage]

The effect of intrathoracic administration of adriamycin with closed tube thoracostomy drainage was investigated on patients with various malignant pleural effusions (13 lung cancer and one each stomach, breast, ovarian cancer, respectively). The doses of adriamycin ranged from 50, 30, 20, to 10 mg given to four groups of 4 cases respectively. Comparative study on effective rates, survival period after the administration, side effects and histopathological changes in autopsied cases was performed. The results obtained were as follows: 1. With regard to effective rates and histopathological changes, no difference was observed in the four groups in term of dose escalation of Adriamycin. 2. 50% survival period was similar within the groups administered 20, 30 and 50 mg of Adriamycin. However, the group receiving 10 mg showed slightly shorter survival period. 3. Although serious side effects were not observed in any groups, minor toxicities were mostly encountered in the 50 mg group. 4. It was concluded that in the treatment of malignant pleural effusion, an appropriate dose of intrathoracic administration of adriamycin was about 20-30 mg.

[Clinical study on the effect of human lymphoblastoid interferon in multiple myeloma]

Ten patients with multiple myeloma were treated with human lymphoblastoid interferon (HLBI). The dosages used were 3 X 10(6) IU to 6 X 10(6) IU of HLBI intramuscularly daily. Out of eight evaluable patients, one partial remission and 3 minor response were observed. More than half patients experienced fever exceeding 38 degrees C and mild myelosuppression. Other toxic effects consisted of anorexia, malaise, liver dysfunction and skin rash. On the basis of our preliminary study, we conclude that HLBI is an effective agent against multiple myeloma.

[Vaccine therapy of malignant melanoma. II. Serological evaluation of the immune responses to the injection using allogeneic melanoma cell vaccine]

Serological studies were performed on melanoma patients for the response of allogeneic melanoma cell vaccine derived from the melanoma cell line SK-MEL-13 (Patient AH) expressing a shared tumor antigen (AH antigen system). AH antigen system was initially identified by autologous typing system and is known to be immunogenic in man. Twenty melanoma patients were treated with multiple intradermal injections of AH vaccine. Their sera were then tested by immunoadherence (IA) and Protein A (PA) assays for antibodies against cell surface antigens of cultured autologous melanoma and SK-MEL-13 cells, followed by extensive absorption assays. The vaccination with allogeneic melanoma cell resulted a serological response to three types of antigens: (1) 4 patients developed antibodies to antigens related to fetal calf serum which was used for the culture of SK-MEL-13 cells; (2) 19 patients developed high titers of antibodies against HLA antigens of SK-MEL-13 cells and; (3) only one patient developed antibody against AH antigen.

Serological responses of melanoma patients to vaccines derived from allogeneic cultured melanoma cells

Twenty melanoma patients were immunized with a whole-cell vaccine prepared from irradiated cells of the melanoma cell line SK-MEL-13. This line, derived from the melanoma of patient AH, expresses a differentiation antigen (initially defined by autologous antibody) which is restricted to melanomas and other cells of neural crest origin. The patients' sera were tested in rosetting assays before and after vaccination for antibodies against cell surface antigens of autologous cultured melanoma cells and SK-MEL-13, and the specificity of observed reactions was defined by absorption tests. Nine patients developed antibodies against autologous cultured melanoma cells. In only one case, patient DM, were these antibodies directed against the AH antigen. In the remaining patients, the antibodies were related to fetal bovine serum in the vaccine growth medium. All patients developed antibodies against cell surface HLA alloantigens of the immunizing cell, SK-MEL-13, as demonstrated by absorption analysis with B cells from the donor of SK-MEL-13 and by serological typing with a panel of HLA typed peripheral blood T cells and B-cell CLL cells. No specificity other than the AH antibody found in patient DM was detected after removal of alloantigens with B cells. We conclude that vaccines prepared from irradiated allogeneic melanoma cells expressing AH antigen, a demonstrably immunogenic differentiation antigen of the melanocyte lineage, are not effective in inducing AH antibody.

Human melanoma antigen AH is an autoantigenic ganglioside related to GD2

AH antigen, initially defined by an antibody present in a melanoma patient, is a cell surface antigen found on approximately 65% of melanoma cell lines. Absorption analysis indicates that AH is a differentiation antigen marking normal and malignant cells of neuroectodermal origin. The AH determinant has been found to be related to GD2 ganglioside.

Numerical changes in blood monocytes in bronchial asthma

Numerical changes in peripheral blood monocytes were examined in 125 patients with bronchial asthma using a new direct method of counting blood monocytes. The number of monocytes in non-attack stages of bronchial asthma was similar to that of healthy controls. The monocyte count observed in overall cases showed a significantly higher value both in pre-attack and attack stages than in non-attack stages. Changes in the number of monocytes in an individual spontaneous asthmatic cycle tended to increase in pre-attack stages, increase more markedly during asthma attacks, then to decrease after the attack was alleviated. Monocytes in cases with a positive test for bronchial challenge to house dust extract changed in almost the same manner as for spontaneous asthma attacks. The number of monocytes did not change during bronchospasm provoked by inhalation of acetylcholine. Exercise-induced asthma patients exhibited indefinite changes of monocytes; that is, some cases showed a significant increase in the number of monocytes related to the asthma cycle, but other cases did not show any appreciable change. These findings suggest that the number of monocytes in the peripheral blood may change in close relation to asthma attacks elicited by allergic reactions.

Long-term survival in acute leukemia in Japan. A study of 304 cases

In a national survey of five-year survivors with acute leukemia, 233 of 304 cases were children under 14 years of age and 71 were adults. There were 107 myeloblastic, 10 promyelocytic, 142 lymphocytic, and 37 undifferentiated leukemias, Forty-five cases at age 3 represented the peak. These long-term survivors have shown a yearly increase in number. In 1972, the number of childhood ALL cases reached 38 with no great changes in ANLL cases. With respect to prognosis among long-term survivors, it seemed that neither type of leukemia nor age at diagnosis were factors influencing the future survival. CNS relapse occurring before the third year was an unfavorable complication for a prognosis beyond five years. Only 8 patients died of leukemia among 155 patients who reached five years in their initial complete remission; 49 of 90 patients who had relapse within five years after diagnosis died of leukemia. From these findings, it seems very important to follow patients for five years in their initial complete remission.

Common leukemia-associated antigen of DBA/2 mouse leukemia detected by tumor rejection and complement-dependent cytotoxicity assays

A cytotoxic antibody for L1210 leukemia cells was found in the (C57BL/6 x DBA/2)F1 (BDF1) mice immunized with L1210 leukemia cells infected with ts mutant of HVJ (HVJ-pi) and challenged several times with uninfected L1210 leukemia cells. These immune mice fell into two categories; high and low responders regarding the titer of cytotoxic antibody produced. The antigen defined by this cytotoxic antibody was present on leukemia cells originating in DBA/2 mice but not on leukemia induced by passage-A Gross virus or spontaneous mammary tumors. This serological cross-reactivity among L1210, P388, and L5178Y leukemia cells has been substantially confirmed by the observation of cross protection against challenge with DBA/2 leukemia cells in immune BDF1 mice. These findings strongly suggested the presence of a common DBA/2 leukemia-associated antigen different from known cell-surface antigens of murine leukemia. The results obtained in the present work also demonstrated the great efficacy of non-cytopathic, viable HVJ-pi-injected tumor cells as an immunogen for inducing tumor immunity.

Immune interferon produced in vitro as a quantitative indicator of cell-mediated immunity

The present study was constructed to provide some information on the possibility of utilizing immune interferon as a quantitative indicator of cell-mediated immunity and to clarify some of the nature of immune interferon-producing cells (IIPC). When spleen cells derived from L cell-sensitized mice were co-cultivated with L cells, interferon appeared in the culture fluid. It was shown by additional experiments that the cells responsible for immune interferon production in this system were T-lymphocytes assisted by macrophages. The pattern of kinetics of immune interferon production in vitro was similar to that of migration inhibitory factor or T cell-mediated cytotoxicity.

Induction of tumor resistance in mice by L1210 leukemia cells persistently infected with HVJ (Sendai virus)

A temperature-sensitive strain of Sendai virus, HVJ-pi, showed little or no cytopathic effect and led to establishment of carrier cultures in several cell lines. By the use of this characteristic, L1210 leukemia cells persistently infected with HVJ-pi (L1210/c--HVJ-pi) was established, almost all of which were positively stained with fluorescent HVJ antibody. They are viable and grow almost equally as uninfected L1210 leukemia cells in vitro. Athymic nude mice (BALB/c, nu/nu), deficient of T-cells, died from intraperitoneal inoculation of L1210/c--HVJ-pi cells as well as by uninfected L1210 leukemia cells. However, viable L1210/c--HVJ-pi cells showed lower transplantability in normal syngeneic mice. This immunological mechanism of rejection was explained by the modification of cell surface membrane due to HVJ-pi infection. The mice which survived the inoculation of 10(5) L1210/c--HVJ-pi cells were able to reject 10(5) uninfected L1210 leukemia cells challenged subsequently. The induction of immune resistance was more prominent in (C57BL/6 x DBA/2)F1 mice or (BALB/c x DBA/2)F1 mice than in DBA/2 mice.