过继性免疫化疗对小鼠和人非小细胞肺癌的治疗效应

临床试验表明,在神经纤维瘤患者中单独应用rh-IL-2或鼠抗GD_2与人的嵌合变异体ch14.18能通过激活LAK细胞或通过外周血单核细胞介导的ADCC作用杀死瘤细胞,通过基因工程将二者融合成为ch14.18-IL-2融合蛋白能特异地将rhIL-2导向肿瘤位点,抑制瘤细胞播散与生长的能力要比单独使用rhIL-2更有效。本研究选用人神经纤维瘤系SKN-AS细胞5×10~5/100μlPBS注入CB-17scid小鼠脾包膜下构建肝转移模型。1d后,对照组腹腔注射0.2mlPBS,其它注射4×10~7人LAK细胞后随机分组分别给予ch14.18、ch14.18 rhIL-2、ch14.18-IL-2治疗发现:对照组与仅给予LAK治疗的肝脏布满转移灶(>500个),肝增重3倍,二者间无显著性差异。LAK ch14.18治疗组肝转移灶显著减少     

过继性免疫化疗对小鼠和人非小细胞肺癌的治疗效应

本文先给细胞毒化学药物,按序给LAK细胞与细胞因子,组成过继性免疫化疗方案。在C57BL/6J鼠体内显示,ADM与LAK有序联合应用对Lewis肺癌株在该鼠肺内瘤结节形成抑制率高达87％,明显高于单用LAK/IL-2的39％(P<0.05)或ADM的26％(P<0.01)。48例非小细胞肺癌治疗结果显示,单用MVP或CAP方案有效率为30％;单用LAK/IL-2有效率为33％,主要表现为对转移灶的治疗作用。而先给CAP或MVP化疗药,按序给LAK/IL-2有效率达69％(P<0.05),并有8％病例肿块消失完全缓解,且未增加副作用。两种方法有序结合,可能增加了对癌细胞亚群的杀伤强度与杀伤谱,因此过继性免疫化疗可作为治疗肺癌的新方案。     

恶性肿瘤“免疫——化学”疗法初试

70年代初期,作者将只用于皮肤试验的二硝基氯苯(DNCB),引伸治疗各种皮肤、疣赘及皮肤恶性肿瘤,均获得良好效果。在国内首先提出疣与体表肿瘤的免疫排斥疗法。鉴于肿瘤患者的免疫能力往往偏低,单靠其自身免疫力不足于控制住顽强增殖的癌细胞,而化疗药物对癌细胞的杀灭呈几何级数,欲全部消灭体内癌细胞单靠化疗也有困难,本文将免疫与化疗结合,以易于客观观察的皮肤恶性肿瘤为模板,试验治疗了20例经病理学确诊的癌瘤,取得18例有效(90%)、15例痊愈(75%)的临床效果。并对15例痊愈者进行了长期随访。方法简便、安全、有效,值得进一步深入探讨。     

Efficacy and Safety of Amoxycillin/Clavulanate (Augmentin®) Twice Daily Versus Three Times Daily in the Treatment of Acute Otitis Media in Children

Abstract

This multicenter, randomized, single-blind study compared the efficacy and safety of a new, twice-daily formulation of amoxycillin/clavulanate (Augmentin®) with the standard three-times-daily formulation. Children with a clinical diagnosis of acute otitis media, aged between 2 months and 12 years, received either amoxycillin/clavulanate 45/6.4 mg/kg/day twice-daily (b.d.) (range 38.3/5.5-76.2/10.9 mg/kg/day) or amoxycillin/clavulanate 40/10 mg/kg/day three-times-daily (t.d.s.) (range 25/6.25-56/14 mg/kg/day) for 7 or 10 days. Patients were evaluated during therapy (Days 3-5), at the end of therapy (Days 7-12) and at follow-up (Days 38-42). At the end of therapy, for the intent-to-treat and per-protocol populations, respectively, clinical success (cure) was achieved by approximately 94% of patients in both treatment groups. A successful bacteriological response at the end of therapy (Visit 3) was documented in 7/9 patients (77.8%) in the twice-daily group and in 11/13 patients (84.6%) in the three-times-daily group. At follow-up (Visit 4), 93.3% of patients in the twice-daily group and 87.9% in the three-times-daily group continued to have a clinically successful response. Both treatment regimens were well tolerated, with most adverse events being of a mild-moderate and transient nature. The most common treatment-related adverse event was diarrhea, occurring in 7.2% of patients in the twice-daily group and in 10.7% of the three-times-daily group. In total, 173 patients (82.8%) in the twice-daily group and 151 patients (73.3%) in the three-times-daily group were compliant with medication.

In conclusion, this study confirms that b.d. amoxycillin/clavulanate is an effective treatment for pediatric acute otitis media and demonstrates that the b.d. and t.d.s. formulations of amoxycillin/clavulanate produce equivalent efficacy. Furthermore, there was a trend towards a higher level of compliance and a lower incidence of drug-related adverse events in the twice-daily compared with the three-times-daily treatment group.     

Activity and safety of combined rituximab with chlorambucil in patients with mantle cell lymphoma

We evaluated the combination of rituximab with chlorambucil in patients with mantle cell lymphoma (MCL) not eligible for aggressive therapy. Fourteen patients (male/female: 9/5) were included (two newly diagnosed, 12 relapsed/refractory). The toxicities were neutropenia, thrombopenia and infection. Nine (64%) patients responded; five (36%) achieved complete remission and four (29%) achieved partial remission. The median progression-free survival for responders was 26 months (95% CI, 4-48). Marrow polymerase chain reaction negativity was attained in seven responders. These results suggest that this schedule may have notable antitumour activity in patients with MCL, including patients in relapse after autologous stem cell transplantation.     

老年套细胞淋巴瘤研究进展

套细胞淋巴瘤(mantle cell lymphoma,MCL)是一种独特的B细胞淋巴瘤,占非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)的3％～10％,除自体干细胞移植(ASCT)外,MCL无其它可治愈的手段.MCL多见于老年男性,多数老年患者常合并基础疾病而不能耐受大剂量化疗和ASCT.全文主要分析MCL的病理生理、治疗、风险分层、预后以及老年患者的治疗选择.     

Relationship between immunological parameters and survival of patients with liver metastases from breast cancer given immuno-chemotherapy

Summary We treated 33 patients with liver metastases from breast cancer by immuno-chemotherapy including adoptive cell transfer between 1987 and 1992. In this study, we examined the change of immunological parameters in the peripheral blood lymphocytes and interleukin-2 (IL-2)-cultured lymphocytes, in primary vs. metastatic breast cancer patients and before vs. after treatment. Moreover, we examined their correlation with therapeutic response and survival after treatment. The immunological parameters used werein vitro natural killer cell activity (% lysis of K562),in vitro autologous tumor-killing activity (% lysis against autologous freshly isolated tumor cells), and proliferation of lymphocytes stimulated with IL-2 and autologous sonicated tumor extract antigen in mixed culture (IL-2-enhanced MLTR). When compared with primary breast cancer patients, patients with liver metastases showed a significant decrease in % lysis of K562 and autologous tumor cells. After treatment, the stimulation index in IL-2-enhanced MLTR increased significantly from the pretreatment level and correlated with survival after treatment. Moreover, non-specific immunological parameters (performance status, lymphocyte count, and transferred cell count and proliferation rate of cultured lymphocytes) were significantly associated with response and prognosis.