Finn Edler Von Eyben

Biochemical markers in advanced testicular tumors: serum lactate dehydrogenase, urinary chorionic gonadotropin and total urinary estrogens.

Twenty‐seven patients with advanced testicular tumors were screened for serum lactate dehydrogenase (LDH) concentration, and 24‐hour urinary excretion of human chorionic gonadotropin (hCG) and total estrogens. The investigation indicates an overall correlation between serum LDH concentration and cancer burden and an overall correlation between the maximum serum LDH and prognosis. It indicates an overall correlation between hCG determined within 2.5 months after the orchiectomy and prognosis. The relation between total estrogens and cancer burden or prognosis does not support the hypothesis that total urinary estrogens are a biochemical marker in testicular tumors.

High‐voltage irradiation and combination chemotherapy for malignant pheochromocytoma

A 29‐ year‐old man with metastatic extraadrenal pheochromocytoma developed paraplegia which reversed completely after megavoltage irradiation of the dorsolumbar spine. Later, treated with cyclophosphamide, vincristine, and dacarbazine, he had a temporary decrease in plasma norepinephrine concentration, a partial recalcification of bone lesions, and a decrease in the need for antihypertensive treatment for 12 months. Irradiation and combination chemotherapy should be evaluated further in the management of malignant pheochromocytoma.

Serum lactate dehydrogenase (S-LDH) and S-LDH isoenzymes in patients with testicular germ cell tumors

SummaryThe activities of serum lactate dehydrogenase (S-LDH) and S-LDH isoenzymes were determined in 252 patients with a history of testicular germ cell tumors (TGCT). Fifteen of 37 patients with TGCT lesions and seven of 215 without had raised levels of S-LDH (above 8.0 μkat/l (480U/l)). Of the patients with TGCT lesions, four had only raised S-LDH-1 levels, one only raise S-LDH-2 (and normal S-LDH), two only raised S-LDH-3 (one with normal S-LDH), and 10 had five combinations of raised levels of S-LDH isoenzymes with a predominance of S-LDH-1. S-LDH and S-LDH-1 correlated significantly with the total tumor volume in the patients with TGCT lesions, especially pronounced in those with lesions from seminoma. Of 34 patients with TGCT metastases, 13 with raised S-LDH levels lived significantly shorter lengths of time than 21 with normal S-LDH. Similarly, 11 with raised S-LDH-1 (above 3.0 μkat/l (180 U/l)) lived significantly shorter times than 23 with normal S-LDH-1. S-LDH is a valuable tumor marker in patients with TGCT, especially in those with seminoma. Routine determination of S-LDH isoenzymes in addition to S-LDH in patients with TGCT is not recommended. In patients with a history of TGCT and an unexplained elevation of S-LDH levels, a raised S-LDH-1 level indicates the presence of TGCT lesions.

Prednimustine (NSC-134087, Leo 1031) treatment of lymphocytic and lymphocytic-histiocytic lymphomas.

Nineteen patients with advanced lymphocytic or lymphocytic‐histiocytic lyphomas were treated with Prednimustine (NSC‐134087, Leo 1031). The median induction dose was 25 mg/m2 a day by mouth (range 11‐42). Ten patients had previously received radiation or chemotherapy, or both. Four patients had a complete remission and eleven a partial remission. The median duration of remission was 12.5+ months for complete responders and 5 months for partial responders. Thirteen patients had a moderate myelosuppression. One patient had urticaria and pruritus and refused further treatment.

A phase II study of combined 5-fluorouracil and mitomycin C in advanced breast cancer

In a Phase II study, 50 patients with advanced breast cancer were treated with a combination of 5‐fluorouracil (1000 mg/m2 on days 1 and 2) and mitomycin C (6 mg/m2 on day 2) (FuMi regimen). The courses were repeated every third to sixth week. Although 35 patients had previously received combination chemotherapy and 40 patients had received endocrine treatment, objective responses were obtained in 29 patients (six complete, 23 partial). The survival was significantly correlated to the response (P < 0.001, log rank test) complete versus partial response, partial response versus no change, no change versus progressive disease. The regimen was well tolerated (19 of 50 experienced nausea). Thirteen patients had hematopoietic toxicity at the day of starting a new course and in six cases, the FuMi regimen had to be discontinued because of longlasting thrombocytopenia. Otherwise, no side‐effect of clinical importance was observed. The FuMi regimen is now compared with Adriamycin regimens and can be recommended for both first line chemotherapy and salvage chemotherapy.

Histologic pattern and growth in two human testis cancers before and after transplantation to nude mice

A yolk sac tumor of the testis and a testicular germ cell tumor with a mixed pattern were serially transplanted to athymic mice. The morphologic pattern in light microscope of each of the transplanted tumors were similar to that of the donor tumor, and both the donor and the transplanted tumors revealed alphafetoprotein reactivity by immunohistochemical staining. The observed growth of the mixed tumor in the donor and in the transplants fitted well with an estimation by the Gompertz equation. The ultrastructure of the transplanted tumors were similar to those previously described for testicular tumors with similar histologic patterns.

Lactate dehydrogenase isoenzyme 1 (LDH-1) in athymic mice with xenografts of a human testicular germ cell tumor

SummaryLactate dehydrogenase (LDH) and LDH isoenzyme activities were determined in tumor tissue, tumor cystic fluid, and serum from athymic mice with transplants of a human testicular germ cell tumor. High activity of LDH-1 was found in tumor tissue and tumor cystic fluid. By histochemical staining LDH was found in all tumor cells. Most tumor cells had a faint staining reaction while some cells dispersed throughout the tumor had a strong staining reaction. The serum LDH-1 in athymic mice with tumor transplants correlated markedly with the tumor volume. The results indicate that serum LDH-1 was derived from the testicular germ cell tumor transplants.

Toxic epidermal injury following intraarterial adriamycin treatment.

Toxic epidermal injury was induced in the right forearm and thumb of a 74‐year‐old woman following two courses of 28 mg/m2 Adriamycin infused in the brachial artery with a three‐week interval. The toxic epidermal injury was treated with a wet dressing solution and a neomycin cream without corticoids; it healed in one month. Afterwards the woman received 22 courses of Adriamycin intravenously or intraarterially in 5.5 or 11 mg/m2 doses, but the toxic epidermal injury did not recur.

Additional lactate dehydrogenase (LDH) isoenzymes in normal testis and spermatozoa of adult man

SummaryAdult human testicular tissue contains up to six previously undescribed lactate dehydrogenase (LDH) isoenzymes in addition to the five LDH isoenzymes normally found and the sixth found in spermatogenic cells and spermatozoa, LDH-X. Additional LDH isoenzymes were also found in spermatozoa but not in seminal fluid or in serum. After electrophoresis one additional LDH isoenzyme of testicular tissue was localized between LDH-1 and LDH-2, two between LDH-2 and LDH-3, two between LDH-3 and LDH-4, and two between LDH-4 and LDH-5. These localizations indicate that the additional LDH isoenzymes are tetramers combining the A and B subunits of the five normal LDH isoenzymes and the C subunit of LDH-X. The additional LDH isoenzymes may be important in the metabolism of spermatogenic germ cells and spermatozoa.

Endodermal sinus tumor treated with high dose cisplatin.

A woman with an endodermal sinus tumor of the ovary stage IV obtained a short but complete remission after treatment with vinblastine, bleomycin and standard dose cisplatin. A second complete remission for 42 + months was obtained with a regimen of vinblastine, bleomycin, etoposide, and high dose cisplatin. This result suggests a dose‐response relationship for cisplatin in ovarian germ cell tumors.