L. Schwarzenberg

TREATMENT OF ACUTE TOTAL-BODY IRRADIATION INJURY IN MAN

The treatment of total-body irradiation injury is essentially based on a very intensive symptomatic therapy (maintenance of patients in aseptic conditions, rational and not systematic use of antibiotics, platelet transfusions when the level of these cells is below 50,000); allogenic bonemarrow transfusion is indicated in case of failure of this symptomatic therapy, whether the dose of irradiation is 100% lethal or less. (auth)

Adriamycin in the Treatment of Acute Leukemias

This paper describes the results of our clinical trial of adriamycin in the treatment of acute leukemias, done after the first results of Bonadonna et al. [1]. A trial of this drug in solid tumors is at present being made by the “clinical screening group” of the European Organisation for Research on the Treatment of cancer (E.O.R.T.C.).

REMISSION INDUCTION WITH POLY IC IN PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA (PRELIMINARY RESULTS)

The oncostatic effect of polyinosinic-polycytidylic acid (poly IC) on several varieties of tumors has been reported previously (Levy et al., 1969) and we have observed its effect on Walker’s tumor. A number of clinical trials have been conducted (De Vita et al., 1970; Krakoff et al., 1970) but they merely confirmed tolerance to the product and did not yield therapeutical results. Although the mechanism of the oncostatic action exerted by polynucleotides on experimental tumors is not precisely defined, it is thought that it is probably multiple, for poly IC is cytotoxic (Braun, personal communication), is an inducer of interferon (Field et al., 1967), is an adjuvant of immunity, as reported by Braun et al. (1968), and as observed by us by studying its effect on the multiplication of cells capable of forming antibodies in mice immunized with sheep red blood cells (Hayat and Mathe, in preparation). From this last-mentioned type of study, we have deduced the hypothesis according to which poly IC could have an action on acute leukemia only when the number of tumor cells is not very high. In fact, we have shown (Mathe, 1968; Mathe et al., 1969) that the adjuvants of immunity in the animal exert a detectable oncostatic action only when the number of cancer cells is low.

Treatment of Blastic Crisis in Chronic Myelocytic Leukemia

The development of an acute leukaemic syndrome can perhaps be considered to be the usual evolution of chronic myeloid leukaemia. Its occurrence is feared and its prognosis is still very poor, despite recent advances in treatment. Twenty-nine patients have been studied, 14 males and 15 females, their ages were 16–71 years (median 40 years). The acute leukaemic syndrome appeared 3 weeks to 7 years after the apparent onset of chronic myeloid leukaemia (median 26 months).

Nonspecific Immune Responses in Hematosarcomas and Acute Leukemias

Non-specific immune responses in cancer patients have been explored in several studies of both cell-mediated and humoral immunity [1, 2, 3, 4, 5, 6]. Since 1968 we have been systematically studying non-specific immune responses in leukemia and hematosarcoma patients [7]. The results are presented below.

Preliminary Data on Acute Leukemia Treatment with ICRF 159

We have treated 10 patients with acute leukaemia, 7 lymphoblastic and 3 myeloblastic, with ICRF 159 or dioxopiperazine propane (Fig. 1). All these patients were resistant to all the drugs so far available. The daily doses were 300 mg/m2.

Blastic Leukemia Complicating Reticulo-Sarcoma and Lympho-Sarcoma

A blastic leukaemia may appear in the course of a malignant lymphoma (Table 1): it is exceptional in Hodgkin’s disease, in follicular lymphoma, in reticulosarcoma, histiocytic type and in lymphosarcoma, lymphocytic type, but it is frequent in reticulosarcoma, histioblastic type (distinction between these two types of reticulosarcoma has been justified and illustrated by Mathe et al., 1967, 1970) and in lymphosarcoma, lymphoblastic type.

Combination of Adriamycine, VM 26, Cyclophosphamide & Prednisone (AVmCP) in Chemotherapy of Lympho & Reticulum Cell Sarcoma (Stages & Topographic Forms III & IV)

The treatment of lymphosarcoma and reticulosarcoma (LRS) has been influenced by two main factors : a) the development of new chemotherapy compounds (1), especially VM26 or demethyl depipodophyllotoxin thehylidene glucoside (objective result rate, 45 % — see refs. 2 and 3) and adriamycin (objective result rate; 50 to 60 % — refs. 4,5 and 6) ; both compounds are particularly effective in treating this type of disease. b) Improved knowledge of the course of the illness, which depends on its histocytological type and anatomical aspect (7). The latter was studied during the most complete possible topographical inventory, including clinical examination radiology, isotopic investigations and exploratory laparotomy (7) including microscope examination of several biopsy specimens (7). There has thus been a considerable decline in the number of Stage I or II LRS cases considered curable by radiotherapy, and a corresponding increase in the number of stage III and IV cases successively treated by maximal regression induction chemotherapy EORTC, sometimes completed by radiotherapy applied to certain “icebergs” in the event of large initial localized tumours (10) ; such radiotherapy may be followed by additional chemotherapy and also by immunotherapy similar to that applied to acute lymphoid leukemia ; this immunotherapy has had remarkable effects on Stage IV leukemic lymphoreticulosarcomas (11).

Methods and Strategy for the Treatment1 of Acute Lymphoblastic Leukemia

Acute lymphoblastic leukaemia (A. L. L.) is a malignant disease in which the proliferating cells are conventionally identified as “lymphoblasts”, cells that are theoretically the precursors of lymphocytes (see Mathe and SEman, 1963).