Kenneth B. Olson

Intracavitary bleomycin in the management of malignant effusions

Instilled bleomycin and thoracostomy were utilized in 38 patients with malignant pleural effusions; the therapy produced a complete or partial response rate of 63%. Toxicity was minimal. In patients with intraperitoneal effusions, bleomycin instillation after drainage produced a complete or partial response in 36%. One patient had severe hypotension and fever. Patients with ovarian and breast carcinoma responded best, among them, effusions were controlled in greater than 70%. Because of its low systemic toxicity, absence of marrow toxicity, and virtual absence of discomfort, we think that the local instillation of bleomycin is indicated in the management of malignant effusions.

Thalidomide (N‐phthaloylglutamimide> in the treatment of advanced cancer

Thalidomide (N‐phthaloylglutamimide) was administered to 21 patients with fourteen types of cancer for periods of 1 to 34 weeks, with total doses ranging from 4.2 to 354.0 Gm. There were mild hemologic and neurological untoward effects. Notumor regression was noted but there was significant subjective palliation in 7 patients. Further study of this drug in patients with advanced cancer is warranted. Palliation was noted to be chiefly improved sedation in disturbed and elderly persons. There was possible arrest of previously rapid growth of tumor in 2 cases.

Clinical features of tumor metastasis to the pituitary

The clinical features of 11 patients with metastases to the posterior pituitary are described. Carcinoma of the breast was the most common primary tumor. Diabetes insipidus was the presenting feature of pituitary involvement and occurred in 0.95% of the patients with breast cancer. Metastatic destruction of the posterior pituitary was the cause in 20% of the patients seen with diabetes insipidus since 1954. Anterior pituitary insufficiency was not seen. Metastasis to the posterior pituitary is more common than is generally thought and should be considered in all patients with cancer, and especially in those with breast cancer, who develop polyuria and polydypsia.

5-Fluorouracil in Cancer: An Improved Regimen

Abstract Fluorouracil is a palliative antitumor agent whose use is limited by toxicity. Methods for reducing toxicity have been described, but the package insert still recommends a course of daily ...

A clinical trial of intravenous and intracavitary bleomycin

Bleomycin, used in two intravenous treatment schedules, induced little tumor regression in 44 patients with advanced carcinoma. Intracavitary instillation resulted in a decrease of fluid reaccumulation in 40% of patients. Bleomycin therapy was associated with toxic reactions in the skin, mucosa, or gastrointestinal tract in 50% of the patients. A severe pulmonary reaction progressing to death occurred in two patients. Cuboidal metaplasia of the alveolar cells with an intra‐alveolar exudate appeared as the primary pulmonary lesion. The principal changes in the lung were in the alveoli and might represent an early phase in the formation of pulmonary fibrosis.

A CLINICAL PHARMACOLOGIC STUDY OF CHEMOTHERAPY AND X-RAY THERAPY IN LUNG CANCER.

Abstract Actinomycin D and 5-fluorouracil, given with x-ray in a dosage regimen sufficient to produce definite but tolerable gastrointestinal and marrow toxicity, did not increase the percentage of patients with carcinoma of the lung showing shrinkage of lesions in the irradiated field. There was no evidence of a more rapid onset of shrinkage of the tumor or of an additive effect at subtotal doses of x-ray. Patient survival was not affected beneficially by the addition of the chemotherapeutic agents. Toxicity was not correlated with responses induced. Patients classified as responders to therapy lived longer than those classified as nonresponders.

Treatment of advanced cancer with active immunization

Forty‐two patients with advanced cancer of various types were actively immunized with autologous tumor coupled to rabbit gamma‐globulin. Only one of the 36 evaluable patients had objective evidence of tumor regression. A partial immunologic survey showed no evidence of delayed hypersensitivity and minimal evidence of humoral antibodies to tumor extract. Toxicity was limited to local immediate hypersensitivity reactions to rabbit gamma‐globulin and granulomatous nodules at the site of the intradermal vaccine inoculations. There was no evidence of tumor growth enhancement. This therapeutic approach of active tumor immunization did not enhance an immunologic tumor rejection mechanism.

Intracellular distribution of trace elements in liver tissue.

Summary Intracellular distribution of 6 metals in liver tissue has been determined for 5 groups of normal rats. Introduction of the Walker rat carcinosarcoma 256 did not change the total level or distribution pattern for the metals determined between treated and control rats. Two specimens of human liver tissue were fractionated and trace metal distribution determined.

Therapy of the malignant lymphomas: I. A study of 116 cases

Abstract Results of therapy in 116 cases of malignant lymphoma are presented. Little difference could be demonstrated in the effectiveness of nitrogen mustard, used as the sole or principal therapy, when compared with the effectiveness of roentgenotherapy in producing and maintaining remissions.

Clinical and biochemical studies of pyridoxine deficiency in patients with neoplastic diseases.

Seventeen patients with advanced neoplastic diseases were fed a formula diet deficient in vitamin B6 for 10 to 80 days. In addition, nine of the patients received the B6 antagonist, 4‐deoxypyridoxine (4‐DOP), for periods ranging from 6 to 46 days. No definite antitumor effect could be observed in any of the patients studied despite ample biochemical and clinical evidence of vitamin B6 depletion. The study confirmed previous reported experiences in man and many other animal species that 4‐DOP accentuates some of the manifestations of vitamin‐B6 deficiency, particularly neurologic and dermatologic side effects. The lymphopenic effect of 4‐DOP was demonstrated only in patients with normal bone marrow. In three of four patients with lymphoproliferative disease the peripheral lymphocyte count rose coincidentally with 4‐DOP administration while in the fourth the rise developed immediately after discontinuation of 4‐DOP and at the peak of toxicity. The study showed evidence of progressive tissue depletion when the patient was fed the deficient diet alone. Addition of 4‐DOP to the deficient diet led to the transient reappearance of measurable pyridoxal phosphate in leukocytes and pyridoxic acid in the urine. This and the slight increase in reticulocyte counts during administration of 4‐DOP raise the possibility that vitamin B6 was mobilized from certain tissue depots by the 4‐DOP and was thus available for oxidation to pyridoxic acid and for use by the less depressed of the enzymes dependent upon vitamin B6.