Showing papers by "Tata Memorial Hospital published in 1989"

Elective versus therapeutic neck dissection in early carcinoma of the oral tongue

Abstract: A prospective, randomized trial was carried out to assess the value of elective versus therapeutic neck dissection in early squamous cell carcinoma of the oral tongue Disease-free survival (median follow-up 20 months) was 52 percent versus 63 percent in patients who underwent hemiglossectomy alone and those who underwent hemiglossectomy and radical neck dissection, respectively (difference not statistically significant) Patients with a tumor depth of less than 4 mm did significantly better than those with a tumor depth of greater than 4 mm; they were also more likely to have uninvolved nodes at elective radical neck dissection compared with those with a tumor depth of greater than 4 mm However, when the survival rates of patients in the two treatment groups were compared with respect to a tumor depth of 4 mm, there was no significant difference between the hemiglossectomy and the hemiglossectomy and radical neck dissection groups A policy of interval elective radical neck dissection only in those with a tumor depth of greater than 4 mm may optimize cure rates and avoid neck dissection in those unlikely to develop neck recurrence

Oncogene amplification in squamous cell carcinoma of the oral cavity

Abstract: We have determined the prevalence of amplification of c-myc, N-myc, L-myc, H-ras, Ki-ras, and N-ras oncogenes in 23 cases of squamous cell carcinoma of the oral cavity, using Southern hybridization analysis of DNA extracted from the primary tumor tissues. Nick-translated oncogene probes and oncogene inserts labeled to high specific activities were used. We observed a 5- to 10-fold amplification of one or more of c-myc, N-myc, Ki-ras and N-ras oncogenes in 56% of the tumor tissue samples, with these oncogenes not being amplified in the peripheral blood cells of the same patients. L-myc and H-ras were not amplified in any of our samples. The oncogene amplifications seemed to be associated with advanced stages of squamous cell carcinomas, with the ras and myc family oncogenes being amplified in stages 3 and 4. Hybridization with N-myc detected an additional 2.3 kb EcoRI fragment, along with the normal 2.1 kb fragment. Our data also demonstrated amplification of multiple oncogenes in the same tumor tissue sample. About 60% of the samples with amplified oncogenes showed simultaneous amplification of 2 or more oncogenes. The results showing different oncogene amplifications in similar tumors, as well as multiple oncogene amplifications in the same tumor, suggest that these oncogenes may be alternatively or simultaneously activated in oral carcinogenesis.

Prophylactic neck dissection in squamous cell carcinoma of oral tongue: A prospective randomized study

Abstract: This paper presents the first report of an ongoing prospective randomised clinical trial in early T1T2N0 carcinoma of the oral tongue. The problems of regular follow-up in an indigent population from the vast rural expanse of India has been successfully overcome in this trial by close personal follow-up. The trial addresses itself specifically to prophylactic vs. therapeutic surgical management of the neck in T1T2N0 patients with cancer of the oral tongue. Overall disease, free survival (median follow-up 22 months) is higher (64% vs. 47%) in the group receiving prophylactic neck dissection. Disease-free survival for those with positive nodes at prophylactic neck dissection was twice that of those who underwent a subsequent therapeutic neck dissection (57% vs. 28%). Contralateral neck node metastasis has been identified as a significant factor in neck failures in those patients undergoing simultaneous prophylactic neck dissection.

Altered keratin expression in buccal mucosal squamous cell carcinoma

Abstract: Cytokeratin pattern was analyzed in 14 moderately differentiated and 12 well-differentiated squamous cell carcinomas of buccal mucosa by SDS-PAGE, immunoblotting and two dimensional electrophoresis. These were compared with patterns of normal buccal mucosa and surrounding areas whenever possible. Normal buccal mucosa expresses keratin No. 4 (59Kd), 5 (58Kd), 13 (54Kd) and 14 (50Kd). Keratin No. 4 (59Kd) and 14 (50Kd) were expressed by 20 of 26 tumors studied, while many of the tumors did not express keratins No. 5 (58Kd) and 13 (54Kd). Keratin No. 1 (67Kd) and 16 (48Kd) were aberrantly expressed by 9 well-differentiated tumors. Keratin No. 17 (46Kd) and 18 (45Kd) were expressed by 10 and 8 tumors of 14 moderately differentiated tumors. Six tumors which showed involvement of alveolar mucosa, expressed some keratins expressed by its normal counterpart. Their altered expression was consistent with the differentiation pattern as stated earlier. Non-expression of keratins 5 and 13 seems to be the result of malignant transformation and is seen in the majority of tumors, while appearance of aberrant keratins seems to be related more to the degree of differentiation of the tumor.

Surgical pathology of squamous carcinoma of the oral cavity: its impact on management.

Abstract: Squamous carcinoma of the oral cavity is relatively common in India. The anterior tongue and buccal mucosa are the two common sites. A retrospective analysis of various histological parameters in surgically treated patients with carcinoma of the anterior tongue (57 cases) and buccal mucosa (71 cases) was undertaken to evaluate their role in prognosis and management. The main findings of this study are the strong correlation between high tumour grade, infiltrative tumour margins, perineural invasion, and tumour size >2 cm and lymph node metastasis at presentation, for both groups of patients. Tumour thickness >5 mm was an additional variable associated with both overt and occult nodal metastases for anterior tongue lesions. All tumours thicker than 5 mm recurred in the untreated N0 neck. Clinically palpable nodes (N1) were falsely positive in 63% of patients with T4 buccal mucosa carcinoma. Grade I histology on biopsy can be used to predict which patients will have negative lymph nodes. Patients with pathologically proven nodal metastases have a poor prognosis. However, the mode of invasion and the presence of perineural invasion in the resected specimen determines the subsequent recurrence of histologically staged N0 cases, most of whom will relapse at the primary site. The low incidence of neck node metastases even in large, buccal mucosa tumours and the virtual absence of “skip” metastases to low nodal sites has made a supraomohyoid lymph node dissection after intraoperative staging a logical alternative to a conventional neck dissection for T3 and T4 buccal mucosa tumours. Finally, carcinoma of the oral cavity in India can be said to be at least two diseases. Cancer of the buccal mucosa and alveolus differs widely in its biological behaviour from carcinoma of the anterior tongue and floor of the mouth.

Epidemiology of head and neck cancers.

Abstract: Head and neck cancers are common in India and account for about 30% of cancers in males and about 13% in females. In males, oral cavity and pharynx are the commonly affected site, followed by larynx. In females, oral cavity is the preponderant site. Reliable data on incidence rates from several cancer registries in India is compared with selected data from the United States and France. A wide variety of tobacco habits prevalent in the country are primarily responsible for the occurrence of these cancers. Among them, bidi smoking, tobacco chewing, and cigarette smoking, in that order, account for a large majority of these cancers. In addition, alcohol and some aspects of the Indian diet have been suspected to contribute to this number of head and neck cancers. The government of India has accorded a high priority to prevention of tobacco-related cancers by the turn of the century in its National Cancer Control Programme.

Lymphokine-activated killer-cell function of lymphocytes from peripheral blood, regional lymph nodes and tumor tissues of patients with oral cancer.

Abstract: Lymphokine-activated killer (LAK) cells, generated from peripheral blood lymphocytes (PBL) from patients with oral cancer or oral leukoplakia and from healthy donors showed comparable lysis of 6 target tumor cell lines, including 3 derived from head and neck and oral cancers. The tumor burden of the host did not appear to influence the systemic LAK activity. LAK activity of lymphocytes infiltrating the tumor tissues (TIL) was also comparable to that of the PBL. Both TIL and PBL showed a parallel increase in proportion of HNK-I ++ and CD-25 + CELLS upon activation with IL-2. The lymph-node lymphocytes (LNL) from metastatic (met) and non-metastatic (non-met) draining lymph nodes, however, showed reduced LAK activity and an increase in CD8 CELLS, in addition to CD25 + and HNK-I + cells, when cultured with IL-2. When IL-2-activated LNL were co-cultured with autologous PBL during IL-2 activation of the latter, a strong suppressive effect was exerted by LNL In contrast, IL-2-activated PBL did not suppress autologous LAK generation in spite of an increase in CD8 + cells seen after activation with IL-2. Frequency distribution of LAK precursors was significantly lower in LNL than in PBL from oral cancer patients. LAK precursor frequency in TIL was comparable to that of PBL. The results show that, in oral cancer, regional lymph nodes may not have adequate IL-2-inducible cytotoxic potential, due to a reduced number of LAK progenitors and possible activation of suppressor cells. Alternatively, TIL can be a potential source for LAK cell function.

Surgery for cancer of the buccal mucosa.

Abstract: Buccal Mucosa cancer is common in India, T4 tumours being the most common (66%). T1 tumours are rarely seen (4%). Disease-free survival (DFS) at 18 mo with surgery alone for T2, T3, and T4 tumours is 57%, 43%, and 21%, respectively. Addition of postoperative radiation therapy (RT) for T3 and T4 lesions increases DFS to 60% and 35%, respectively. Marginal mandibulectomy is advocated for lesions close to the lower gingiva when the bone is clinically and radiologically uninvolved. The local control rate with marginal mandibulectomy is 79%. In T3/T4 tumours, results with supraomohyoid dissection are comparable to radical neck dissection when the upper jugular nodes are histologically negative. In T4 tumours, histological grading forms an important parameter for identification of a favourable subset. In well-differentiated tumours DFS was 48% with surgery and 72% with surgery and postoperative RT; in moderately differentiated tumours it was 12% and 21%, respectively; and in the poorly differentiated group there were no survivors.

Epidemiology of esophageal cancer

Abstract: The incidence of cancer of the oesophagus is high in India but not as high as the rates reported from the Caspian Littoral of Iran. Incidence data available for three places in India--Bombay, Madras, and Bangalore--show regional variations. In Bombay, the rates for males are high compared to Madras and Bangalore. A case control study of 503 oesophageal cancer cases in males and 634 controls registered at the Tata Memorial Hospital during the period 1980-84 was carried out to determine the association of oesophageal cancer with two types of dietary practices, viz., vegetarian and non-vegetarian, in addition to tobacco and alcohol habits. In the presence of an alcohol habit, the relative risk for tobacco chewing and smoking was observed to be high in the non-vegetarian group compared to the vegetarian group. A vegetarian diet was protective. Further studies are suggested to confirm this finding.

Pattern of Infection in Hematologic Malignancies: An Indian Experience

Abstract: Ninety-nine consecutive patients who received cytotoxic therapy for acute leukemia were retrospectively studied to determine the pattern of infection at the Tata Memorial Hospital, Bombay, India. In all, 224 infective episodes occurred in these patients. Bacterial infection was the commonest type, accounting for 152 (67.9%) of 224 infective episodes, followed by fungal and viral infections (15.6% and 14.3%, respectively). Gram-negative organisms (Pseudomonas and Klebsiella) were the commonest bacterial organisms isolated, constituting 38 (76%) of 50 positive cultures; infection with Staphylococcus was rare (1007). Infective hepatitis, malaria, and systemic tuberculosis were responsible for fever with neutropenia in 20, 4, and 2 patients, respectively. Three hundred fifty-two patients with lymphoproliferative malignancies were also retrospectively studied to determine the pattern of infection. Only 53 infective episodes were recorded. In these patients, in contrast to those with acute leukemia, viral infection (33 [62.3%] of 53) and pulmonary tuberculosis (18 [34%] of 53) were frequently seen. It is interesting that 50%o of our patients with hairy cell leukemia also had tuberculosis. Bacterial infection was conspicuous by its absence. Knowledge of the prevailing pattern of infection permits the development of investigative and therapeutic approaches of optimal efficacy. Patients with hematologic malignancies are susceptible to infectious complications. Many factors predispose this patient population to infection, including local factors due to tumor-specific deficiencies in host defense mechanisms due to malignant processes and cytotoxic chemotherapy. Infections can be classified into three categories, as determined by

Monoclonal antibody against human squamous-cell-carcinoma-associated antigen.

Abstract: Mouse monoclonal antibody (MAb) 3F8E3 (IgG3k) was developed against the head and neck cancer cell line LICR-LON-HN2. Subjected to indirect immunofluorescence, the MAb reacted exclusively with SCC cell lines and showed no reactivity with normal or transformed mouse and human non-SCC cell lines and hematopoietic cell lines. The radiolabelled MAb showed an affinity constant of 1.8 x 10(8) M-1 with HN2 cells and identified 2.07 x 10(4) sites/cell by Scatchard analysis. It identified 2 peptides from membrane extracts of HN2 cells by Western blotting. Avidin-biotin-complexed immunoperoxidase staining on cryostat sections of tumors from various tissues revealed that 3F8E3 reacted mainly with the membrane antigens of well differentiated SCC cells of oral cavity, larynx, esophagus, lung, uterine cervix, metastatic nodes of patients with oral cancer, and dysplastic cells in oral leukoplakia. The MAb did not react with poorly differentiated cells of Ca esophagus, adenocarcinoma of breast, stomach and colon, renal-cell carcinoma and soft-tissue sarcoma.

Radiotherapy of carcinoma of the buccal mucosa.

Abstract: A retrospective study of 399 cases of buccal cancer, presenting to the Tata Memorial Hospital, Bombay, during January to December 1984 was undertaken to define the efficacy of various treatment modalities in different clinical stages. Analysis of treatment technique and response was carried out in 185 cases that completed adequate therapy. Sixty percent of patients with stage I and II disease (21/35) received radiation therapy alone as the primary modality of treatment. Patients (150) with stage III or IV disease received palliative irradiation (57 cases), radical surgery (54 cases), or a combination of both (39 cases). The 2-year disease-free survival (DFS) rates were 48% for radiotherapy and 46% for surgery in the early stages and 5% and 33%, respectively, for advanced stages. Radiotherapy with a modified technique is recommended for the early-stage cancers and preoperative irradiation with adjuvant chemotherapy or hyperthermia for the advanced stages.

Mutagenicity and carcinogenicity of smoked meat from Nagaland, a region of India prone to a high incidence of nasopharyngeal cancer.

Abstract: The incidence of nasopharyngeal cancer (NPC) in the northeastern part of India is reported to be high. A possible correlation between consumption of smoked meat by the tribal people and high suceptibility to NPC has been postulated. The charred portion of smoked beef and meat of other animals was collected from this area, extracted with acetone and the extract (SME) was tested using the Ames test as well as for chromosomal aberration in mouse bone marrow cells and carcinogenicity using Swiss bare mice. It was observed that SME was mutagenic in all five strains of Salmonella typhimurium (TA98, TA1538, TA100, TA1535 and TA1537), with or without S9 mix, and was clastogenic in a mammalian test system. SME also has the potential to induce skin papilloma as well as systemic tumours in Swiss bare mice. Chemical analysis of SME revealed the presence of low concentrations of volatile nitrosamines.

Modulation of Natural Killer and Antibody-Dependent Cellular Cytotoxicity by Interferon and Interleukin-2 in Chronic Myeloid Leukemia Patients in Remission

Abstract: Our earlier studies demonstrated that about 55% of chronic myeloid leukemia (CML) patients in remission exhibited impaired natural killer (NK) cytotoxicity (low NK responders) while antibody-dependent cellular cytotoxicity (ADCC) of these patients, on chicken red blood cells as targets, was within normal range. In this paper, we have attempted to modulate the NK cytotoxicity of CML patients in remission with interferon (IFN) and interleukin-2 (IL-2) singly or together. ADCC using K562 target-directed monoclonal antibody (MAb) 4.6E10 was also modulated by treating the effectors with IFN or IL-2. Pretreatment of nonadherent mononuclear cells from peripheral blood (NAPBMNC) with IFN or IL-2 was found to result in 20 and 21% increase in target cell lysis in case of healthy donors, 79 and 98% increase in case of CML normal NK responders, and 164 and 159% increase in case of CML low NK responders. Combined use of IFN and IL-2 potentiated further the lymphocytotoxicity to 25% in healthy donors, 135% in normal NK responder CML patients and 283% in low NK responder CML patients. This treatment resulted in restoration of cytotoxicity of the latter group of patients to a normal level. The augmentation was seen in 80–100% CML patients. Although ADCC with chicken red blood cells as targets was within normal range, ADCC mediated with MAb to K562 cells was significantly lower in CML low NK responders (24.5%) than CML normal NK responders (42.4%) and healthy donors (65.9%). When the effectors were treated with IL-2 or IFN, much higher ADCC responses were obtained. Combination of treatment of effectors with IL-2 and targets with 4.6E10 augmented the cytotoxicity of low NK responder CML patients to normal levels.

In vitro modulation of natural killer cell activity in non-Hodgkin's lymphoma patients after therapy.

Abstract: The depressed natural killer (NK) activity, antibody-dependent cellular cytotoxicity (ADCC) and NK cytotoxic factor cytotoxicity in untreated non-Hodgkin's lymphoma patients were found to be elevated after chemotherapy. In vitro treatment of the effector NK cells with interferon α could augment the NK activity in normal subjects and treated patients to a comparable degree. Chemotherapy mainly affected the post-binding events in the NK cytotoxic process by causing an increase in the active killing potential of the NK cells. This study provides a better understanding of changes in the NK cytotoxic mechanism in non-Hodgkin's lymphoma patients and the role of interferon in this process.

lnterleukin‐2 mediated regulation of mitogen‐activated T cell reactivity from different lymphoid sources in patients with squamous cell carcinoma of the oral cavity

Abstract: Peripheral blood lymphocytes (PBL) from patients with oral cancer (treated and untreated), oral leukoplakia and healthy donors; lymphocytes from metastatic and non-metastatic lymph nodes (met LNL and non-met LNL); and tumor infiltrating lymphocytes (TIL) were tested for proliferative response to mitogen PHA (phytohemagglutinin) and its augmentation by recombinant Interleukin-2 (rIL-2), for expression of Tac antigen (CD25) and for production of IL-2. Depressed PHA responses were found in PBL of treated and untreated patients, and in TIL. Addition of IL-2 could bring about 16% to 31% augmentation in lymphocyte response to PHA from all the three sources. PBL from 50% of healthy donors, 45% of patients with leukoplakia, 25% untreated oral cancer patients and 35% treated oral cancer patients showed IL-2 mediated augmentation of PHA response. While, 40% non-met LNL samples, 70% met LNL samples and only 23% TIL samples showed increased mitogen induced proliferation by IL-2. The augmented levels of PHA response of PBL from treated and untreated patients, and of TIL, were still below those of normal PBL. PBL from patients with leukoplakia, treated oral cancer patients and TIL showed depressed CD25 antigen expression. Depressed IL-2 production was observed only in PBL of leukoplakia patients. Thus the IL-2 mediated events of T cell activation from different lymphoid sources in patients with oral cancer did not correlate with their proliferative responses.

1,10-phenanthroline potentiates cytotoxicity of hydroxyurea in human chronic myeloid leukemia cells.

Abstract: The effect of the divalent hydrophobic metal chelator 1,10-phenanthroline was evaluated alone and in combination with the antineoplastic agent hydroxyurea on human chronic myeloid leukemia cells. The compound at concentrations of 10 and 5 μg/ml significantly (p +2 and Zn. The results strongly suggest the utility of the iron-chelating agent along with hydroxyurea for further evaluation to achieve a better therapeutic result in the clinic.

Combined treatment modalities in esophageal cancer.

Abstract: Esophageal cancer has been conventionally treated with surgery and radiotherapy for many years. The overall results for all cancers are poor because the majority of patients present late for therapy. The advent of increasingly effective chemotherapeutic drugs--used as single agents and in combination--for squamous cancer has added one more modality in the management of esophageal cancer. Previous publications from this institution and in the literature have indicated the palliative efficacy of such chemotherapy management along with surgery and radiotherapy, particularly for advanced disease. The selection of an individual patient likely to respond to chemotherapy, the number of cycles to be given, and their exact timing in relation to radiotherapy and/or surgery still remains a matter of debate. With appropriate endoscopic and imaging techniques, chemotherapy responsive and non-responsive lesions can be generally identified; even radiotherapy responses can be predicted with appropriate evaluation in a majority of cases. This assessment avoids delay in instituting the most appropriate type of treatment for a given patient with esophageal cancer. Cisplatinum-based front-loading (anterior) chemotherapy was used in 75 patients of locally advanced esophageal cancer (greater than 7.5 cm on esophagogram) with a 76% (57/75) overall response rate and 10% (8/75) showing complete responses as judged by esophagogram, endoscopy; and surgical resection in 7. Patients evaluable for 2- and 3-year survivals show a control rate of 35% and 24%, respectively, which is better than hitherto reported for advanced esophageal cancer. Similar reports are now available in the literature, and further studies with combined therapy should be pursued to improve the salvage rates in the usual advanced case of esophageal cancer.

Modulation of mitoxantrone cytotoxicity by verapamil in human chronic myeloid leukemia cells.

Abstract: Calcium channel-blocking agent verapamil has been established to be an effective drug to modulate the action of many anticancer drugs. In this study, we examined the effect of verapamil on the cytotoxicity of mitoxantrone in human chronic myeloid leukemia (CML) cells. Mitoxantrone alone exhibited dose-dependent inhibition of DNA biosynthesis in CML cells. The addition of verapamil (3.3 microM) enhanced the responsiveness of CML cells to mitoxantrone (1 microgram/ml) cytotoxicity indicated by significant increased inhibition of thymidine incorporation (p less than 0.001). The present study demonstrates the possible efficacy of verapamil in the chemotherapy of CML with mitoxantrone.

Intermediate-dose methotrexate and cisplatin in the treatment of advanced epidermoid esophageal carcinoma. Response rate and disease-free survival.

Abstract: Seventeen patients with inoperable locoregional disease (epidermoid carcinoma of the esophagus) were treated only with two courses of intermediate-dose methotrexate (200 mg/m2 on day 1) and cisplatin (20 mg/m2/d for 5 days). According to the response criteria, 14 (82.4%) achieved a good response (GR) and 3 (17.6%) showed no response (NR). The median recurrence-free survival time was 5 months (range, 2 to 16 months) in seven patients with regular follow-up. Three patients are still alive and disease-free at 37+, 44+, and 51+ months. No patient received radiotherapy or surgery after chemotherapy until recurrence. This combination schedule appears to be effective in advanced esophageal carcinoma.

Palliative management of esophageal cancer.

Abstract: Symptomatic esophageal cancer is usually an advanced disease and only palliation is possible in the majority of the cases. Endoscopic methods of palliation are becoming very popular because of the simplicity and the low incidence of morbidity and mortality. Endoscopic laser therapy, dilatation, placement of endoprosthesis, bipolar electrocoagulation, and injection therapy are the various methods currently in use. The advantages and disadvantages of different methods are discussed and the need for controlled trials highlighted.

Corticosteroid-responsive pure red cell aplasia in rheumatoid arthritis and its association with pregnancy: a case report.

Abstract: Pure red cell aplasia (PRCA) often occurs secondary to drug therapy for rheumatoid arthritis (RA) However, idiopathic PRCA in RA is very rare Though different immunosuppressive therapies have been tried in the past with variable responses, there has been no case report in adults of favourable response to corticosteroids alone We report a rare case of PRCA in RA, which responded to steroid therapy Subsequently, the patient relapsed twice, during the first trimester of consecutive pregnancies The association of PRCA with RA and pregnancy is discussed

Rat renal mesenchymal tumor as an experimental model for human congenital mesoblastic nephroma: I. Induction.

Abstract: The effect of low-dose (2 Gy) radiation on ethylnitrosourea (ENU)-induced neoplasms was studied in Sprague-Dawley and Holtzman strains of rats. With a 60 mg/kg dose of ENU administered on day 1 in Sprague-Dawley rats, 18.4% of the neoplasms induced were found in the kidney. When the same dose of ENU was given on day 10, the incidence of kidney tumors fell to 2.8%. Prior (2 Gy) radiation on day 9 enhanced kidney tumor induction to 16.1%, a trend also observed in the case of ENU-induced neural tumors. In Holtzman rats, 40 mg/kg ENU induced more kidney tumors (12.5%) when given on day 4 than on day 0, and prior irradiation enhanced the ENU-induced kidney tumors even though the interval between irradiation and carcinogen administration was fairly long--4 days.

Natural killer and lymphokine‐activated killer cell‐mediated cytotoxicity in patients with oral cancer

Abstract: Peripheral blood lymphocytes (PBL) from untreated and treated oral cancer patients, lymph node lymphocytes (LNL) from metastatic (met) and nonmetastatic (non-met) lymph nodes, and tumour infiltrating lymphocytes (TIL) were tested for natural killer (NK) and lymphokine activated killer (LAK) cell cytotoxicity using appropriate targets in a short-term chromium release assay The results showed that while both NK and LAK functions of PBL from oral cancer patients were comparable to those of normal healthy donors, the NK activity of metastatic and nonmetastatic LNL and TIL was highly compromised On the other hand, potent LAK activity could be generated from all three lymphoid populations Individual patients showing low NK activity displayed good LAK cytotoxicity, indicating that endogenous cells with low NK potential have adequate ability to respond to interleukin 2 (IL-2) LAK activity tested on autologous tumour targets revealed that TIL were the best source of LAK cells, followed by PBL and LNL

Danazol in treatment of angio-immunoblastic lymphadenopathy

Abstract: The clinical manifestations of angio-immunoblastic lymphadenopathy (AILD) suggest that there is an abnormality in the immune system. Most patients with AILD die from opportunistic infections associated with lymphocyte depletion. As chemotherapy further increases the already high susceptibility of infections, the therapeutic management of AILD is difficult. The achievement of complete remission (CR) by the patient described here using a danazol-based regimen raises the hope that treatment of this disease with a noncytotoxic drug may be possible. The rationale behind and advantages of using danazol are discussed.

Nutrition and esophageal cancer.

Abstract: Several case control studies in esophageal cancer employing a food-frequency dietary questionnaire suggested a fairly uniform dietary pattern which could be implicated in the causation of the disease. Although various micronutrients (vitamins and trace elements) have also been found to have either a positive or negative association, findings were more clear-cut for the different food items contributing the micronutrients than for the specific micronutrients themselves. The difficulties encountered in dietary interviews in case control studies are discussed. Nutritional supplementation has a theoretical rationale, but clinical experience with randomized trials did not support the same.