[Pulmonary tuberculosis in the compromised host--report of the 30th B series of controlled trials of chemotherapy--Cooperative Study Unit of Chemotherapy of Tuberculosis of the National Sanatoria in Japan]

The 445 cases of pulmonary tuberculosis in compromised host were investigated. Summary of the analysed results were as follows; (1) The major underlying diseases of compromised hosts with tuberculosis were diabetes mellitus and various types of cancer. (2) The major risk factors for advancement of tuberculosis were malnutrition and iatrogenic suppressions due to long term use of corticosteroids and anticancer agents. (3) The patients with malnutrition in the compromised hosts showed poor prognosis. (4) The chest roentgenogram of tuberculous lesion was difficult to improve in these patients when their clinical stage of tuberculosis had been advanced at admission. (5) The diagnosis and management of pulmonary tuberculosis in compromised host remain as a serious problem in recent years.

Restorative effect of muroctasin on leukopenia caused by anticancer chemotherapy in lung cancer. Comparative study by envelope method

N2-[(N-Acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin), a derivative of muramyl dipeptide, is known to have the activity to augment the number of white blood cells (WBC) via colony-stimulating factor. Muroctasin has been expected to be applied to leukopenia caused by anticancer chemotherapy. When WBC decreased to less than or equal to 3,000/mm3 after the 1st course of chemotherapy, 131 patients with lung cancer, who were previously classified by the combination regimens of chemotherapy, were enrolled in the study and randomized into 3 groups, 200 micrograms (H), 100 micrograms (L) and untreated control (C) groups. The patients were then subcutaneously treated once daily for 6 consecutive days. WBC and its differential count were measured on Days 4, 7 and 15 after commencement of the study. WBCs in H and L groups were recovered greater than in C group. In WBC differential count, the recovery of neutrophil was prominent in muroctasin treated groups. The portion of immature neutrophil in the bone marrow was also increased by muroctasin treatment. A restorative effect on WBC and neutrophil counts was also confirmed only in the second course of H group. On the other hand, fever and pain in the injected site as side effects were common in the H group and L group in both of courses. In this study, the usefulness of muroctasin in leukopenia was suggested when administered at dosages of 200 micrograms for 6 days.