Letter: Toxicity of intravenous Corynebacterium parvum

Metabolic changes following the intravenous infusion of Corynebacterium parvum in man

The acute changes in concentrations of key blood metabolites and liver function tests were measured following intravenous infusion of Corynebacterium parvum in 9 healthy patients who had recently undergone resection of a colorectal cancer. The following results were obtained: 1) Blood glucose, lactate and ketone body concentrations significantly increased over a 5 hour study period; 2) blood alanine fell during the same period; 3) plasma bilirubin, GOT and urea were significantly elevated 24 hours after C. parvum 4) plasma albumin and cholesterol concentrations were significantly lower 24 hours after C. parvum. These changes are similar to the alterations in hepatic metabolism previously described in clinical bacterial infections, and indicate parenchymal cell damage and reduced synthetic activity. They are potentially important in relation to the treatment of cancer with combined modalities where drug metabolism or excretion may be affected.

An evaluation of Corynebacterium parvum during remission maintenance therapy in pediatric patients with acute lymphoblastic leukemia

The biologic impact and clinical toxicity of Corynebacterium parvum administered at a dose of 5 mg/M2 by intravenous or subcutaneous routes were evaluated in 18 children receiving combination chemotherapy for maintenance of acute lymphoblastic leukemia (ALL) in remission. Several nonspecific immunologic and hematologic parameters were evaluated. Patients were also monitored for changes in cutaneous sensitivity to histamine. No changes in any parameter were observed in patients after only one course of C parvum injection. However, after 6-10 courses, glass-adherent peripheral blood leukocytes of C parvum-treated patients augmented the response of PHA-stimulated autologous lymphocytes. In all nine patients studied who received C parvum injection subcutaneously for at least six months, there were significant increases in the mean bone marrow myelocyte-erythrocyte (ME) volumes compared to pretreatment values. These results suggest that periodic evaluations are desirable in patients receiving repeated administration of C parvum, since changes in immunologic and hematologic responses may be demonstrable only after several injections. In contrast to the reported experience in adults, subcutaneous C parvum administration children was not well tolerated, whereas intravenous infusion was generally well tolerated.

Toxicity manifestations following intravenous Corynebacterium parvum administration to patients with ovarian and cervical carcinoma

Manifestations of clinical toxicity were evaluated following 341 courses of intravenous Corynebacterium parvum adjuvant immunotherapy in patients with ovarian and cervical carcinoma. Most patients exhibited symptoms of minor toxicity, which decreased in intensity as subsequent courses of therapy were administered. Temperature elevations to 38.5 degrees C. were the most objectively measured signs of toxicity but temperature elevations greater than 38.5 degrees C. occurred following only 20.5 per cent of the infusions. Blood pressure alterations were not a serious problem and no serious central nervous system or renal toxicity was noted. The minor side effects should not preclude the use of C. parvum as an immunopotentiating agent if it is shown to be beneficial in the treatment of human malignant disease.