Nonspecific activation of complement by leukemic cells

Non-specific activation of complement (NAC) on cell membranes via the alternative pathway was studied by using leukemic cells and cells from a generalized reticulohistiocytosis. The cells were treated with normal human serum in veronal-buffered saline containing ethyleneglycoltetra-acetate and Mg⁺⁺. Since human erythrocytes (HuE) are known to adhere to complement-reacted cell membranes in an immune adherence reaction, complement activation on the cell membrane was confirmed by the rosette formation of HuE which is due to the generation of C3b molecules on the cell membrane. Only cells from Schilling-type acute monocytic leukemias and cells from a generalized reticulohistiocytosis possessed NAC ability. All other leukemic cells tested, as well as normal hematopoietic and lymphoreticular cells, were NAC-negative. Furthermore, none of the mitogens tested generated NAC ability on normal peripheral blood lymphocytes.     

A randomized phase II multicenter trial to explore efficacy of weekly intraperitoneal in comparison with intravenous paclitaxel administered immediately after gastrectomy to the patients with high risk of peritoneal recurrence: final results of the INPACT trial

Background

Intraperitoneal administration of paclitaxel had been considered a promising option to treat peritoneal metastasis, the most frequent pattern of recurrence in gastric cancer after D2 gastrectomy, but its safety and efficacy after gastrectomy had not been fully explored.

Methods

A phase II randomized comparison of postoperative intraperitoneal (IP) vs. intravenous (IV) paclitaxel was conducted. Patients with resectable gastric linitis plastica, cancer with minimal amount of peritoneal deposits (P1), or cancer positive for the peritoneal washing cytology (CY1) were eligible. After intraoperative confirmation of the above disease status and of resectability, patients were randomized to be treated either by the IP therapy (paclitaxel 60 mg/m² delivered intraperitoneally on days 0, 14, 21, 28, 42, 49, and 56) or the IV therapy (80 mg/m² administered intravenously using the identical schedule) before receiving further treatments with evidence-based systemic chemotherapy. The primary endpoint was 2-year survival rate.

Results

Of the 86 patients who were randomized intraoperatively, 83 who actually started the protocol treatment were eligible for analysis (n?=?39, IP group; n?=?44, IV group). The 2-year survival rate of the IP and IV groups was 64.1% (95% CI 47.9–76.9) and 72.3% (95% CI 56.3–83.2%), respectively (p?=?0.5731). The IP treatment did not confer significant overall or progression-free survival benefits, and was associated with particularly poor performance in patients with residual disease, including the CY1 P0 population.

Conclusions

We were unable to prove superiority of the IP paclitaxel over IV paclitaxel delivered after surgery to control advanced gastric cancer with high risk of peritoneal recurrence.

     

Thoracic intradural extramedullary lesions causing progressive myelopathy as an initial manifestation of granulomatosis with polyangiitis: a case report and review of literature

Context: To our knowledge, only a few reports regarding the spinal involvement of granulomatosis with polyangiitis (GPA)—also termed as Wegener's granulomatosis—have been published. However, all these cases reportedly exhibited epidural tumor-like lesions or dural thickening.

Findings: We report the case of a 57-year-old woman with progressive myelopathy caused by multiple spinal lesions with GPA, which appeared to be protruding inwards, within the dura mater, on magnetic resonance imaging (MRI); these lesions were difficult to distinguish from intradural tumors. Moreover, these lesions exhibited low intensity on both T1- and T2-weighted MRI, and showed prominent enhancement on gadolinium-contrast imaging. Resection biopsy was effective for both diagnosis and the recovery of the neurological deficit.

Conclusion: Based on these findings, we suggest that GPA lesions can exhibit variable patterns in the spine. Nevertheless, clinicians should consider the possibility of GPA in such cases, particularly when multiple, inwardly protruding tumor-like lesions are detected within the dura mater on MRI.