Active immunotherapy in malignant melanoma.
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Biomedical subjects
Publications and source records attributed to M Deane.
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The prognosis for patients who undergo surgery for stage IIB malignant melanoma is poor. Animal studies have suggested that BCG and tumour cell vaccines given together may provide effective immunotherapy. To assess the effectiveness of this treatment 15 patients with stage IIB malignant melanoma who had their tumour excised were studied. Seven were treated conservatively, and eight were vaccinated with BCG and autologous irradiated cells. Three vaccinated patients suffered widespread recurrence within three months. All four vaccinated patients who suffered a recurrence within the first year died, while none of the three controls with recurrent disease died. In view of this alarming trend the trial was stopped after a year. BCG and the tumour cells may have enhanced the tumour growth, although there was no apparent reason for this. The results of uncontrolled or unrandomised trials that have suggested that this treatment is beneficial should be treated with scepticism.
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Surveys were performed to assess the acute health effects of aerial application of malathion bait over a large urban area. Three indirect attempts to assess utilization of health care services were made: (1) surveillance of a major hospital emergency department was undertaken, (2) ambulance dispatches were reviewed, and (3) emergency treatments for asthma at a university hospital were reviewed. These assessments were negative but insensitive. Prevalence of self-reported symptoms was assessed with two surveys that were subject to severe time constraints. Personal interviews of the same individuals, before and after the spraying, were conducted: one was conducted by telephone and the other by residential visit. Results indicated no detectable increase in acute morbidity. Also, after the spraying, there was a decrease in anxiety-related symptoms.