Tetsuhiko Nakamura

Treatment for unresectable hepatoma via selective hepatic arterial infusion of lymphokine‐activated killer cells generated from autologous spleen cells

Nonspecific tumoricidal effectors, called lymphokine‐activated killer (LAK) cells, can be induced from the tumor‐bearers spleen in vitro. The adoptive transfer of such LAK cells to a patient with unresectable hepatoma was performed in this study. About 2.4 × 109 LAK cells generated from the autologous spleen were adoptively transferred to the patient via hepatic arterial catheter. Signs of toxicity encountered with LAK cell infusions comprised chills and fever only. Chemical studies of hepatic, renal, and hematologic parameters were normal; pulmonary function studies revealed no changes after infusion. With the transfer of LAK cells, serum alpha‐fetoprotein (AFP) levels were markedly decreased and ascitic fluid retention was transiently reduced. Though the therapeutic effect was transient, these trials offered hope for a new therapeutic approach to unresectable hepatoma. Further, the availability of large amounts of recombinant interleukin‐2 (rIL‐2) may now make widespread use of this approach possible. Cancer 58:1001–1006, 1986.

A case of the aggravation of peritonitis carcinomatosa due to the intraperitoneal interleukin-2 administration.

進行胃癌により癌性腹膜炎をきたした症例で, interleukin-2 (IL-2, 8×105JRU, 週2回) の間欠的腹腔内投与法を施行したところ, 明らかな免疫能の低下と臨床症状の増悪, 腫瘤の増大をきたした1症例を経験した.本症例は入院時 (未治療時) の腹腔内浸出細胞peritoneal exudate cell (PEC) に強いlymphokine activated killer (LAK) 活性が検出されていたが, IL-2投与によりLAK活性は有意に低下し, 腹水中のprostaglandin E2 (PGE2) 濃度は著明に上昇した.PECの細胞亜分画はモノサイト/マクロファージが多数を占めCD3陽性分画, CD16陽性分画の減少をみた.本症例は, このような著明な免疫機能の低下とともに腹部腫瘤の増大, 腹水増加をきたしIL-2投与後25日目に不幸な転帰をとった.IL2による腫瘤の急速な増大, 臨床症状の増悪の機構を検討するとともに癌性腹膜炎に対するIL-2投与の適用について考察を加えた.