Matsuro Fukushima

The effect of thymectomy on myasthenia gravis, thrombocytopenia, and granulocytopenia associated with thymoma: Report of a case

We report the case of a 47-year-old woman with thymoma who developed myasthenia gravis, thrombocytopenia, and granulocytopenia, simultaneously, the concurrent association of these four disorders being extremely rare. Thymectomy was performed, and, during the post-thymectomy course, there were surprising findings concerning the recovery of not only the myasthenia gravis but also of the hematologic disorders. Immediately after thymectomy, the myasthenic symptoms completely disappeared, and the granulocyte and platelet counts recovered to within the normal range within a few days. The laboratory data revealed no difference between pre- and post-thymectomy in the release of cytokines (tumor necrosis factor; TNF, interleukin; IL-2, and IL-6), anti-acetylcholine receptor antibody, or platelet-associated IgG. On the other hand, the serum level of anti-neutrophil cytoplasmic antibody (p-ANCA), against the myeloperoxidase of the granulocytes was dramatically decreased, after thymectomy, showing a significant correlation with the granulocyte count. According to our survey of the literature, this is the first report to show that the removal of a thymoma led to the dramatic resolution not only of myasthenia gravis but also of other associated diseases. It is possible that p-ANCA may be regulated by thymoma, thus causing severe granulocytopenia.

Specific cancer immunotherapy adjunctive to surgery for advanced gastric cancer: a report of six long term survivors.

SummaryIn order to improve the results with non-curatively resected advanced gastric cancer, we have tried specific cancer immunotherapy adjunctive to surgery. In this article, six long term survivors (median 6.2 years) are reported.

Specific immunotherapy for non-curatively resected gastric cancer.

The prognosis of patients with advanced gastric cancer treated with non-curative resection is very poor. In order to improve patient prognosis, we have tried specific immunotherapy as an adjunct to surgery since January 1968. Sixty-two patients with gastric cancer underwent non-curative resection during the period of this study. Twenty-eight of these patients were treated with specific immunotherapy after surgery, and 34 patients received no additional therapy. The five year survival rate was 35 per cent in the former group, and zero in the latter. No significant difference in the degree of tumor extension and invasion was noted between the two patient groups. We concluded that specific immunotherapy as an adjunct to non-curative resection for advanced cancer is worthy of further study.

Immunological responsiveness and adjunct immunotherapy in lung cancer

Immunocompetency was assessed before and after the operation in 40 patients with lung cancer by skin reaction against tuberculin (PPD) and dinitrochlorobenzene (DNCB), lymphocyte response to PHA, proportion of T-cells, macrophage migration inhibition test (MIT) and the presence of blocking factor. MIT was positive in 27 per cent and blocking factor was positive in 42 per cent. Immune response paralleled the clinical stage of the lesion. In curative resection cases, the immune response rose postoperatively, but declined in non-resectable or recurrent cases. The influence of postoperative radiation therapy, cancer chemotherapy and host mediated agents on the patients was observed. The feasibility of adjuvant specific immunotherapy is discussed.