PubMed Health⌕ Search

Biomedical subjects

F R Eilber

Publications and source records attributed to F R Eilber.

At least 109 records · Page 6Linked to original sources
PubMed1976

Effects of operation on immune response in cancer patients: sequential evaluation of in vitro lymphocyte function.

The effect of operation on in vitro lymphocyte function in 35 cancer patients was studied. Lymphocyte proliferative responses to phytohemagglutinin (PHA), poke-weed mitogen (PWM), and concanavalin A (Con A) were measured by 3H-thymidine incorporation. Sheep red blood cell (SRBC) rosette formation also was quantitated. These tests were performed preoperatively and at 24 hours, one week, and 4 weeks postoperatively. Intra-abdominal and intrathoracic procedures, transfusions, and longer operating times depressed the lymphocyte proliferative response. However, an increased lymphocyte proliferative response was noted in sarcoma patients 24 hours postoperatively, possibly as a result of lowered tumor burden. Several of these changes still were evident 4 weeks after operation. Rosette formation also decreased significantly 24 hours postoperatively in patients who had intrathoracic or intra-abdominal procedures, but returned to preoperative levels after one week. In general, operation appears to cause transient depression of lymphocyte function in some cancer patients. However, lymphocyte function returns to normal by the fourth postoperative week in most patients.

Concanavalin A↗
PubMed1976

Immunotherapy in malignant melanomaa.

Accumlated evidence suggests that human neoplasms contain antigens that elicit humoral and cellular immunity in the immunocompetent host. A recent summary report showed that Stage II melanoma patients with metastases to regional lymph nodes had a lowered incidence of recurrence and a higher incidence of survival following surgery and postoperative BCG immunotherapy. To verify these findings, clinical trials are now under way in which we radomized melanoma patients into groups to compare treatment by surgery alone with surgery and BCG only, or surgery and BCG in combination with allogeneic melanoma cell vaccine. Serum samples from each patient are monitored by in vitro techniques to define those methods which best correlate to clinical course. Hopefully, such correlations can be used to monitor response to immunotherapy before disease is clinically apparent. Although immunotherapy does not cause regression of far advanced disease, it undoubtedly will be beneficial against subclinical, microscopic tumor.

Antigens, Neoplasm↗
PubMed1975

Immunotherapy of malignancy in humans. Current status.

Many observations support the premise of a close relationship between immunologic competency and the growth of human cancer. Immunotherapy against cancer in animals has been established. Its function appears to be adjunctive to other treatment modalities that first lower tumor burden. These findings are demonstrated in both clinical and laboratory studies of cancer in humans. At the present time, intralesional injections of BCG vaccine in immunocompetent patients with intradermal metastases are most effective. Immunotherapy with topical administration of 2,4 dinitrochlorobenzene is the treatment of choice in selected patients with squamous or basal cell carcinoma.

Adjuvants, Immunologic↗
PubMed1975

Radionuclide photoscanning. Usefulness in preoperative evaluation of melanoma patients.

The results of radionuclide scans (liver, bone, and brain scans and whole-body scans using bleomycin tagged with radioactive indium [111In]) performed on 100 melanoma patients during their initial evaluation were reviewed to determined whether or not they effected a change in clinical staging or therapeutic decision. Patients were classified as stage I (primary disease) or stage II (regional disease) on the basis of regional lymph node dissections. Only one patient (stage II) of 73 stage I and II patients had an abnormal finding on the initial radionuclide scan. Fifteen of 26 patients thought to be stage III (disseminated disease) on clinical grounds had abnormal findings on at least one scan. A therapeutic change as a result of scanning occurred in the stage II patient after abnormal bone and whole-body scans. As an initial routine screening test for stage I and II melanoma patients, radionuclide scanning was unproductive and rarely influenced therapeutic decisions.

Adult↗
PubMed1975

Sequential evaluation of general immune competence in cancer patients: correlation with clinical course.

An evaluation of general immunologic reactivity was performed in 116 patients with malignant melanoma and in 40 patients with skeletal and soft tissue sarcoma who received adjunctive immunotherapy. An excellent correlation was observed between delayed cutaneous hypersensitivity to DNCB and the clinical extent of malignancy. Eighty percent of patients with Stage I disease were DNCB positive, whereas only 37% of Stage III patients were reactive on initial testing. A method for sequential evaluation of DNCB response was established, and revealed that variations in immune reactivity occurred that also correlated with the patient's clinical course. Persistence of nonreactivity to DNCB or conversion from a reactive to an anergic status was associated with postoperative recurrence in more than 80% of the patients. Conversely, conversion from an anergic to a reactive status was observed if tumor control was achieved. These results indicate that the defect in systemic immunity is closely associated with tumor cell burden, and that sequential evaluation of DNCB reactivity is a clinically useful monitor of disease progression.

Adolescent↗
PubMed1975

Delayed cutaneous hypersensitivity and peripheral lymphocyte counts in patients with advanced cancer.

One hundred eighty-three patients with advanced solid neoplasms were tested for their ability to react to four common skin test antigens (tuberculin PPD, streptokinase-streptodornase, mumps, and Monilia) and their ability to develop delayed cutaneous hypersensitivity (DCH) to 2, 4 dinitrochlorobenzene (DNCB). All patients were followed for at least 6 months or until death. Histologic tumor types studied were: melanoma (65), sarcoma (28), squamous cell carcinoma (23), and adenocarcinoma (67). The rate of progression of disease within 6 months of testing was lower in patients who had a positive response to a challenging dose of 50 mug of DNCB. Reactivity to recall antigens had no prognostic value except in patients with adenocarcinomas. Among patients with adenocarcinoma, those who reacted strongly to DNCB and one or more skin test antigens had the best prognosis, while those who were nonreactive to all had the worst prognosis (progression rate: 18% vs. 78%). Peripheral lymphocyte counts were related to the results of DCH to DNCB and skin tests. The preseence or absence of lymphocytopenia (count less than 1000/mm3) had prognostic value in patients who had positive skin test(s). In such patients, the disease progression rate was much higher in patients who were anergic to DNCB and who were lymphocytopenic (90% vs. 40%). These data suggest that DCH to DNCB, recall antigens, and peripheral lymphocyte counts are useful immunologic measurements in patients with advanced cancer. Although the prognostic value of each individual test is relatively limited, the predictive worth can be increased when multiple tests are employed. Pertinent findings reported in the literature are reviewed.

Adenocarcinoma↗
PubMed1975

Osteosarcoma. Results of treatment employing adjuvant immunotherapy.

The treatment of patients with osteosarcoma continues to result in few survivors despite advances in surgery and radiotherapy. Since the primary site of failure is pulmonary, it is apparent that a systemically active adjuvant must be employed if a cure is to be achieved. Because of the experimental evidence for an immune response against osteosarcoma and because of the potential systemic activity of the immune system, a trial of postoperative adjuvant immunotherapy was begun. Seventeen patients received immunotherapy consisting of BCG and an allogeneic tumor cell vaccine following surgical removal of all gross tumors. Eighteen per cent (3/17) of the patients who received immunotherapy remained alive and free of disease compared to 0/12 who did not. An analysis of the 14 patients with recurrence, revealed that the median time to recurrence was 3.0 months in both groups. It is, therefore, apparent that at the time of initiation of immunotherapy subclinical metastasis must already have been present. Therefore, on the basis of this study we conclude that adjuvant chemotherapy should be employed to further reduce the tumor cell burden in order for immunotherapy to be effective for osteosarcoma.

Antigens, Neoplasm↗
PubMed1974

BCG immunotherapy of malignant melanoma: summary of a seven-year experience.

Over the past 7 years, 151 patients with malignant melanoma have been treated with BCG immunotherapy alone or as an adjunct to surgical therapy. Direct injection of metastatic melanoma lesions limited to skin resulted in 90% regression of injected lesions and 17% regression of uninjected lesions in immunocompetent patients. Approximately 25% of these patients remained free of disease for 1 to 6 years. Direct injections of BCG into nodules of patients with subcutaneous or visceral metastases resulted in a lower incidence of local control and no long term survivors. Attempts to improve the results of immunotherapy in these patients by palliative surgical resection of large metastatic lesions to lower tumor burden followed by BCG immunotherapy significantly improved the results although many patients still developed recurrent disease. Early results of a clinical trial combining BCG immunotherapy with regional lymphadenectomy in patients with melanoma metastatic to lymph nodes have been encouraging and promising. Further controlled clinical trials are necessary to elucidate the role of BCG in immunotherapy. However, since BCG is but one of a number of potential immunologic adjuvants, even more effective immunotherapy will be possible as further knowledge of the interactions of cellular and humoral immunity is acquired.

Anaphylaxis↗