[Biological aspects of paraneoplastic syndromes]. / Biologické aspekty paraneoplastických syndromu.

The author discusses some aspects of indirect manifestations of tumourous diseases, i.e. paraneoplastic syndromes. The already known paraendocrine hormone secretion by tumours is supplemented by recent knowledge from the biology of tumourous diseases incl. indirect manifestations where an important part is played by autocrine secretion of regulatory, mainly growth factors.

High dose alpha-2-recombinant interferon in the treatment of malignant lymphoproliferative diseases. A pilot study.

In the presented clinical study, 10 patients with malignant lymphoproliferative diseases (2 with acute lymphoblastic leukemia, 3 with Hodgkin's disease, and 5 with non-Hodgkin's lymphoma), resistant to standard therapy, were administered alpha-2-recombinant interferon at a dosage of 120 x 10(6) IU as a continuous 48 h i.v. infusion. The second administration was performed after an interval of 1 month. A therapeutic response was seen in 50% of the patients, of them there were two complete remissions (in the two acute lymphoblastic leukemia patients) and 3 partial remissions (in 2 patients with Hodgkin's disease and in 1 patient with low malignant non-Hodgkin's lymphoma). In four patients with high malignant non-Hodgkin's lymphomas the treatment did not evoke any response, and in 1 patient with the same diagnosis progression was noted after the treatment. The toxic effects of the drug were in accord with literature data, and although high doses of alpha-2-recombinant interferon were administered, it was not necessary to interrupt the treatment in any of the patients. Considering the therapeutic effect of this immunomodulator used in the treatment of malignant lymphoproliferative diseases, our results are promising, nevertheless further studies will be required.

Alteration of beta-2-microglobulin level in malignant lymphoproliferative diseases after a high dose of alpha-2-recombinant interferon.

A group of 10 patients with malignant lymphoproliferative diseases resistant to any standard therapeutical modalities were treated with a high dose of alpha-2-recombinant interferon (alpha-2-rIF). Alpha-2-rIF was administered at a total dose of 120 x 10(6) IU in a continuous infusion during 48 h. Two cycles of alpha-2-rIF immunotherapy were employed with an interval of 1 month in between each. Serum and urinary beta-2-microglobulin (B2M) were examined prior to alpha-2-rIF application and on days 2, 4, 6 afterwards. Alpha-2-rIF treatment induced an increase in serum B2M as noted on day 2 followed by a decline to below the normal range. The initial increased value was significantly higher as compared to either the pretreatment value or the normal physiological range. The reduced B2M serum level was protracted and lasted until the second cycle of treatment. Similar but not so great changes in B2M serum values were noted during the second application of alpha-2-rIF. The changes of B2M level in the urine, although less convincing, mimic those observed in the serum. The present results confirmed the biological activity of alpha-2-rIF in malignant lymphoproliferative diseases.

Alterations of plasma levels in malignant lymphoma.

Fibrinogen levels were investigated in the plasma of a group of patients with malignant lymphoma consisting of M. Hodgkin's and non-Hodgkin's lymphoma, and were found to be significantly higher in an acute onset of the disease and in relapses, than in a control group of healthy blood donors. In the terminal stages, fibrinogen levels in the plasma were observed to decline towards the upper normal limits. Plasma fibrinogen levels are considered to be a good indicator of the activity of the disease.

Humoral and cellular immunity in long-term surviving patients with malignant lymphoma.

Humoral and cellular immunity was followed in a group of long-term surviving patients with malignant lymphoma, viz. serum immunoglobulins quantitatively, T lymphocytes by the E rosette and B lymphocytes by the EAC rosette methods. A single examination of this group was compared with data from a control group of normal humans and a smaller group of patients with malignant lymphoma at an advanced stage. A significant increase of IgA (3.73 g/l onthe average) was noted in the surviving group as against both the controls (mean 2.31 g/l in the healthy and 1.23 g/l in the patients with advanced disease). IgM values were found to be significantly decreased in the latter patients (mean 0.85 g/l) in comparison with both the other groups. The rosette tests yielded lower absolute values of E rosettes in the same patients with advanced lymphoma (mean 725/ml) as against the healthy subjects (mean 1525/ml) and the long surviving patients (mean 1277/ml). The absolute value of active E rosettes in the two groups of patients was lower (741 and 580/ml) than that in the healthy group (mean 1067/ml). A percentage determination of rosette values proved to be of low statistical significance.

BCG vaccination in Hodgkin's lymphogranuloma.

Results of active non-specific immunotherapy in 25 patients suffering from Hodgkin's disease are given. All of them, being at the stage of a complete remission (residual disease) were divided into two groups according to the clinical stage: group 1 at the stage I and II and group 2 at the stage III and IV. To each vaccinated patient a non-vaccinated control, being at the same stage of disease and of approximately the same age, was selected by applying the method A--B. Results as to the survival time and the remission duration were in both vaccinated groups significantly longer although less significant in patients with an advanced stage of the disease. The present report is to be considered preliminary and the research work is carried on.