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1.
Reproduction ; 160(1): 117-127, 2020 07.
Article in English | MEDLINE | ID: mdl-32485669

ABSTRACT

The life-history theory suggests that parental experience of the environment is passed to offspring, which allows them to adapt to prevailing conditions. This idea is supported from the mother's side, but to a much less extent from the father's side. Here, we investigated the effect of immunising fathers on pre- and neonatal development and on immune and neuroendocrine phenotypes of their offspring in C57BL/6J mice. Nine days before mating, fathers were intraperitoneally injected with the immunogenic protein keyhole limpet hemocyanin (KLH). Females mated with immunised males had less pre-weaning mortality of newborns compared to those mated with control males. Although the antibody response to KLH was similar for the male offspring of control and immunised fathers, the mass indexes of their main immune organs and their androgen response differed significantly. The mass indexes of the thymus and spleen in adult male offspring of immunised fathers were higher compared with the control offspring. The plasma testosterone levels were significantly decreased after KLH administration in the male offspring of control but not of immunised fathers. This was correlated with changes in sperm average path and straight-line velocities. Finally, excitatory neurotransmitters prevailed over inhibitory ones in the amygdala of the progeny of immunised fathers, while in control offspring, the opposite occurred. This is indicative of complex behavioural changes in the offspring of immunised fathers, including sexual ones. Therefore, the paternal experience of foreign antigens modulates the immune and neuroendocrine systems of their progeny, suggesting possible survival and reproductive adaptations to parasitic pressure.


Subject(s)
Cell Communication , Hemocyanins/adverse effects , Immunization/adverse effects , Phenotype , Prenatal Exposure Delayed Effects/pathology , Reproduction , Spermatozoa/physiology , Animals , Animals, Newborn , Female , Male , Mice , Mice, Inbred C57BL , Pregnancy , Prenatal Exposure Delayed Effects/etiology , Spermatozoa/cytology
2.
Biochim Biophys Acta Mol Basis Dis ; 1863(6): 1473-1478, 2017 06.
Article in English | MEDLINE | ID: mdl-28188832

ABSTRACT

An experimental model of Guillain-Barré Syndrome has been established in recent years. Rabbits develop disease upon immunization with a single dose of an emulsion containing bovine brain gangliosides, KLH and complete Freund's adjuvant. Within a period of four to ten weeks after immunization, they began to produce anti-ganglioside IgG-antibodies first, and to show clinical signs of neuropathy afterwards. In addition to gangliosides, KLH is a requirement for antibody production and disease triggering. Although KLH is commonly used as an immunological carrier protein, an anti-KLH-specific immune response was necessary for induction of both events. KLH is a glycoprotein carrying most of the immunogenicity in its glycan moiety. Between 20% to 80% of anti-ganglioside IgG-antibodies present in sick rabbit sera cross-reacted with KLH, indicating that both immune responses are related. The terminal Gal-ß(1,3)-GalNAc glycan (present in gangliosides and KLH) is proposed as "key" antigenic determinant involved in inducing the anti-ganglioside immune response. These results are discussed in the context of the "binding site drift" hypothesis.


Subject(s)
Adjuvants, Immunologic/administration & dosage , Antibody Formation/drug effects , Guillain-Barre Syndrome , Hemocyanins/adverse effects , Immunization/adverse effects , Models, Immunological , Adjuvants, Immunologic/pharmacology , Animals , Disease Models, Animal , Guillain-Barre Syndrome/chemically induced , Guillain-Barre Syndrome/immunology , Guillain-Barre Syndrome/pathology , Hemocyanins/pharmacology , Humans , Rabbits
3.
Biomed Res Int ; 2015: 648143, 2015.
Article in English | MEDLINE | ID: mdl-26425548

ABSTRACT

We report the first evaluation of plant-made conjugate vaccines for targeted treatment of B-cell follicular lymphoma (FL) in a Phase I safety and immunogenicity clinical study. Each recombinant personalized immunogen consisted of a tumor-derived, plant-produced idiotypic antibody (Ab) hybrid comprising the hypervariable regions of the tumor-associated light and heavy Ab chains, genetically grafted onto a common human IgG1 scaffold. Each immunogen was produced in Nicotiana benthamiana plants using twin magnICON vectors expressing the light and heavy chains of the idiotypic Ab. Each purified Ab was chemically linked to the carrier protein keyhole limpet hemocyanin (KLH) to form a conjugate vaccine. The vaccines were administered to FL patients over a series of ≥6 subcutaneous injections in conjunction with the adjuvant Leukine (GM-CSF). The 27 patients enrolled in the study had previously received non-anti-CD20 cytoreductive therapy followed by ≥4 months of immune recovery prior to first vaccination. Of 11 patients who became evaluable at study conclusion, 82% (9/11) displayed a vaccine-induced, idiotype-specific cellular and/or humoral immune response. No patients showed serious adverse events (SAE) related to vaccination. The fully scalable plant-based manufacturing process yields safe and immunogenic personalized FL vaccines that can be produced within weeks of obtaining patient biopsies.


Subject(s)
Hemocyanins/immunology , Lymphoma, Follicular/immunology , Nicotiana/metabolism , Vaccines, Conjugate/adverse effects , Vaccines, Conjugate/immunology , Adolescent , Adult , Aged , Demography , Female , Hemocyanins/adverse effects , Humans , Immunity, Cellular , Immunity, Humoral , Male , Middle Aged , Patient Selection , Polysaccharides/immunology , Vaccination , Young Adult
4.
Zhonghua Wai Ke Za Zhi ; 46(23): 1819-22, 2008 Dec 01.
Article in Chinese | MEDLINE | ID: mdl-19094797

ABSTRACT

OBJECTIVES: To prepare and purify NogoA vaccination for treatment of spinal cord injury. To study the safety and immune effect of this vaccination. METHODS: Artificial NogoA-13 polypeptide was coupled with KLH to improve the immunogenicity of vaccination. Sixty three-week-old Wistar female rats were divided into 3 groups randomly. Group A was immunized with NogoA vaccination, group B with incomplete freund's adjuvant + complete freund's adjuvant; group C with KLH. Rats received abdominal cavity immunization. The level of antibody and the binding capability were detected with ELISA. The safety of vaccination was evaluated by the incidence and severity of experimental autoimmune encephalomyelitis (EAE). RESULTS: The IgG antibody against the NogoA-13 polypeptide had been detected with ELISA in group A. A value of serum presented regular gradient during multiple proportion dilution. In group B and C, no antibodies were detected. The statistical significant difference in A value was revealed between group A and B, C group. No statistical significant difference was found in A value between group B and group C and non-immunized negative control serum. The features of EAE were not found in the immunized rats. CONCLUSIONS: NogoA polypeptide vaccination can stimulate the antibody against the polypeptide. The immune effect of this vaccination is confirmed by binding reaction revealed in the ex vivo experiment. The good safety of vaccination is revealed by no features of EAE found in the immunized rats.


Subject(s)
Myelin Proteins/immunology , Spinal Cord Injuries/immunology , Animals , Encephalomyelitis, Autoimmune, Experimental/chemically induced , Female , Hemocyanins/adverse effects , Hemocyanins/immunology , Immunoglobulin G/immunology , Myelin Proteins/adverse effects , Random Allocation , Rats , Rats, Wistar , Safety , Vaccination
5.
Drugs R D ; 4(4): 236-40, 2003.
Article in English | MEDLINE | ID: mdl-12848588

ABSTRACT

Biomira is developing a therapeutic cancer vaccine [THERATOPE] for treatment of breast and other cancers. This profile has been selected from R&D Insight, a pharmaceutical intelligence database produced by Adis International Ltd. THERATOPE consists of the mucin antigen, sialyl-Tn (STn), a carbohydrate located on the surface of breast, colorectal and ovarian cancer cells, conjugated to keyhole limpet haemocyanin (KLH). Merck KGaA has acquired a worldwide licence to THERATOPE for treatment of breast cancer. Under the terms of the licence, Biomira and Merck KGaA, via its US affiliate, EMD Pharmaceuticals, will jointly market the vaccine in the US. Merck KGaA holds exclusive marketing rights for the rest of the world, except in Canada (where Biomira retains rights), Israel and the Palestine Autonomy Area. Merck KGaA is now collaborating on phase III development for breast cancer. Biomira stands to receive $US150 million in licence, milestone payments and equity investments. The development costs will be shared between the two companies in North America but Merck KGaA will be solely responsible for these costs in countries outside the US. Previously, Chiron Corporation had purchased a licence to THERATOPE in 1997; however, Chiron terminated this agreement in June 2000. Under the terms of the termination, Biomira paid Chiron $US2.25 million to compensate the company for its investment in the development of THERATOPE. In addition, Biomira will make another payment of $US3.25 million to Chiron upon FDA approval of the vaccine. No further payments or royalties will be made. In the third quarter of 2002, an independent review of interim data from the trial was conducted. This was the fifth scheduled review of the data by the Independent Data Safety Monitoring Board (DSMB), all of which produced a positive response. Following the completion of the review, the DSMB stated that the trial should continue and that it had no safety concerns regarding this trial. Although the data, to which Biomira and Merck KgaA are blinded, did not meet the predetermined statistical significance for either endpoint at the time of the review, both companies have chosen to continue with the trial. Biomira has since announced that the p-value for the interim survival analysis was set at 0.01, while it is set at 0.03 for final survival analysis. The tighter criteria was set for the interim analysis to potentially give the companies the opportunity of applying for marketing approval earlier than expected. Final analysis of the trial will take place in mid-2003. If these analyses indicate therapeutic efficacy, Biomira will meet the FDA and Canadian regulatory officials to obtain marketing approval for the vaccine for breast cancer under the accelerated review guidelines. Assuming a best-case scenario, the vaccine could be filed for approval in 2004. The phase III trial was initiated following positive preliminary results achieved in a bridging study in patients with metastatic breast cancer in the US and UK. Biomira announced final results of the bridging study in May 1999. The results confirmed that antibody titres against the STn antigen were significantly higher in patients treated with the improved formulation of THERATOPE, compared with the corresponding titres of patients in the phase II trials of the old formulation of THERATOPE. In September 2002, the first patient was enrolled in a phase II THERATOPE trial, which is enrolling patients with metastatic breast cancer who are taking either an aromatase inhibitor or fulvestrant. Approximately 95 patients will be enrolled in the trial at up to 12 US sites. The study is primarily designed to evaluate THERATOPE's ability to induce an immune response in these patients. However, the safety and tolerability of the aromatase inhibitor plus THERATOPE, and the fulvestrant plus THERATOPE combinations will also be evaluated. The trial has not been designed to evaluate the efficacy of the two combinations. The US FDA has granted fast-track status tranted fast-track status to THERATOPE for development as an adjunct to first-line combination chemotherapy in responding patients with metastatic breast cancer. A phase II trial in patients with metastatic colorectal cancer has been completed in the US; positive preliminary results from this trial were released in May 2001. On 24 November 1999, Biomira announced that it had licensed two patents covering methods of preventing growth of cancer cells expressing a mucin-type glycoprotein. The patents have been issued in the US and are pending in Japan and Canada. When issued in Japan, the patents will provide additional protection for THERATOPE in that country. The patents were licensed from Dr Sen-itiroh Hakomori of the Biomembrane Institute in Seattle, with whom Biomira has also entered into a research collaboration. Biomira announced in April 2003 that following examination of its re-issue application by the US Patent and Trademark Office, its patent 5798090 was re-issued (RE 38046) with additional claims. These additional claims represent broader patent coverage. The additional coverage will last until 2015. Earlier, in February 2000, Biomira announced an expansion of equity line for up to $US100 million; a 3-fold rise that was done without any additional shares of Biomira stock being issued. In June 2002, Biomira stated that it believes the market size for THERATOPE in the US, Europe and Japan to be approximately 184000 patients for the indication of metastatic breast cancer, of which the US would be 100000, Europe 75000 and Japan 9000. For the indication of colorectal cancer, the total market population for THERATOPE is expected to be 183000 patients, of which the US has been estimated at 100000, Europe 75000 and Japan 9000.


Subject(s)
Adjuvants, Immunologic/therapeutic use , Antigens, Tumor-Associated, Carbohydrate/therapeutic use , Cancer Vaccines/therapeutic use , Hemocyanins/therapeutic use , Neoplasms/drug therapy , Adjuvants, Immunologic/adverse effects , Adjuvants, Immunologic/economics , Antigens, Tumor-Associated, Carbohydrate/adverse effects , Antigens, Tumor-Associated, Carbohydrate/economics , Breast Neoplasms/drug therapy , Breast Neoplasms/immunology , Cancer Vaccines/adverse effects , Cancer Vaccines/economics , Clinical Trials as Topic , Costs and Cost Analysis , Drug Industry/economics , Female , Hemocyanins/adverse effects , Hemocyanins/economics , Humans , Injections, Subcutaneous , Marketing of Health Services , Neoplasms/immunology , Treatment Outcome
6.
Eur Arch Otorhinolaryngol ; 259(5): 257-61, 2002 May.
Article in English | MEDLINE | ID: mdl-12107529

ABSTRACT

Apoptosis was induced in the cochlea by the injection of keyhole limpet hemocyanin (KLH) into the endolymphatic sac of guinea pigs and immunohistochemically examined. Keyhole limpet hemocyanin was injected into the right endolymphatic sac. The temporal bones were fixed via cardiac infusion of fixative and immunohistochemically stained for caspase-activated deoxyribonuclease or caspase 3. Endolymphatic hydrops became evident in the cochlea 1 day after the injection of keyhole limpet hemocyanin (n=6). The temporal bones in the control group did not show any caspase-activated deoxyribonuclease or caspase 3 immunoreactivity (n=6). Immunoreactivity for caspase 3 was detected in the supporting cells of the organ of Corti, the stria vascularis and the spiral ganglion cells. Caspase-activated deoxyribonuclease was also detected in the same areas. These findings suggest that apoptosis is involved in the pathogenesis of endolymphatic hydrops. This phenomenon could lead to cochlear dysfunction, as seen in endolymphatic hydrops.


Subject(s)
Apoptosis/immunology , Caspases/analysis , Caspases/immunology , Deoxyribonucleases/analysis , Deoxyribonucleases/immunology , Endolymphatic Hydrops/immunology , Endolymphatic Hydrops/pathology , Meniere Disease/immunology , Meniere Disease/pathology , Adjuvants, Immunologic/adverse effects , Animals , Caspase 3 , Cochlea/immunology , Cochlea/pathology , Disease Models, Animal , Endolymphatic Hydrops/chemically induced , Guinea Pigs , Hemocyanins/adverse effects
7.
Clin Cancer Res ; 6(5): 1693-701, 2000 May.
Article in English | MEDLINE | ID: mdl-10815887

ABSTRACT

Our objective was to determine whether an immune response can be generated against MUC1 peptide and against tumor cell MUC1 after vaccination with MUC1-keyhole limpet hemocyanin (KLH) conjugate plus QS-21 in breast cancer patients. Nine patients with a history of breast cancer but without evidence of disease were treated with MUC1-KLH conjugate plus QS-21, containing 100 microg of MUC1 and 100 microg of QS-21. s.c. vaccinations were administered at weeks 1, 2, 3, 7, and 19. Peripheral blood was drawn at frequent intervals to assess antibody titers. Skin tests were placed at weeks 1, 3, 9, and 21 to determine delayed type hypersensitivity reactions. Common toxicities included a local skin reaction at the site of the vaccine, usually of 4-5 days' duration, and mild flu-like symptoms usually of 1-2 days' duration. High IgM and IgG antibody titers against synthetic MUC1 were detected. IgG antibody titers remain elevated from a minimum of 106-137 weeks after the first vaccination. Binding of IgM antibody to MCF-7 tumor cells was observed in seven patients, although there was minimal binding of IgG antibody. Two patients developed significant antibody titers post-high-dose chemotherapy and stem cell reinfusion. There was no evidence of T cell activation. This MUC1-KLH conjugate plus QS-21 was immunogenic and well tolerated in breast cancer patients. Additional trials are ongoing to determine the optimal MUC1 peptide for use in larger clinical trials. Further investigation of vaccine therapy in high-risk breast cancer is warranted.


Subject(s)
Breast Neoplasms/prevention & control , Hemocyanins/therapeutic use , Mucin-1/therapeutic use , Peptide Fragments/therapeutic use , Vaccination , Adjuvants, Immunologic , Adult , Amino Acid Sequence , Antibodies/blood , Antibodies/drug effects , Breast Neoplasms/immunology , Cancer Vaccines/adverse effects , Cancer Vaccines/immunology , Cancer Vaccines/therapeutic use , Diarrhea/chemically induced , Fatigue/chemically induced , Female , Fever/chemically induced , Headache/chemically induced , Hematologic Diseases/chemically induced , Hemocyanins/adverse effects , Hemocyanins/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin G/drug effects , Immunoglobulin M/blood , Immunoglobulin M/drug effects , Middle Aged , Molecular Sequence Data , Mucin-1/adverse effects , Mucin-1/immunology , Nausea/chemically induced , Neoplasm Staging , Peptide Fragments/adverse effects , Peptide Fragments/immunology , Skin/drug effects , Skin/pathology , Time Factors , Treatment Outcome , Tumor Cells, Cultured
8.
Clin Cancer Res ; 5(1): 77-81, 1999 Jan.
Article in English | MEDLINE | ID: mdl-9918205

ABSTRACT

BEC2 is an anti-idiotypic mouse monoclonal antibody that mimics GD3 ganglioside. Previous clinical trials demonstrated that intradermal immunization using 2.5 mg of BEC2 with BCG or i.v. immunization with 10 mg of BEC2 can induce anti-GD3 antibodies in a subset of patients. We hypothesized that combining these two immunization strategies might be more effective in inducing anti-GD3 antibodies and that conjugation of BEC2 to keyhole limpet hemocyanin (KLH) would further enhance the immunogenicity of BEC2. In this clinical trial, 18 melanoma patients who were free of disease after complete surgical resection within 1-6 months received intradermal immunizations on weeks 0, 2, 4, 6, and 10 with 2.5 mg of BEC2 conjugated to KLH and mixed with BCG (BEC2-KLH/BCG). Booster immunizations of 10 mg of unconjugated BEC2 were administered i.v. on weeks 24, 37, and 50. Four of 18 patients (22%) developed IgM anti-GD3 antibodies. No IgG anti-GD3 antibodies were detected. All four responding patients developed anti-GD3 IgM during immunization with BEC2-KLH/BCG; only one patient demonstrated a reboost of the IgM anti-GD3 titer during the i.v. immunizations. Thirteen of the patients are free of melanoma (3 after undergoing re-resection for local relapse); 14 patients (78%) remain alive with a median follow-up of 28 months. These results confirm our previous trial, showing that BEC2 with BCG can induce anti-GD3 antibodies in patients. The data do not provide evidence that conjugation to KLH increases the immunogenicity of BEC2 when it is administered with BCG.


Subject(s)
Adjuvants, Immunologic/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antibodies, Neoplasm/biosynthesis , BCG Vaccine/immunology , Cancer Vaccines/immunology , Gangliosides/immunology , Hemocyanins/immunology , Immunoconjugates/immunology , Melanoma/therapy , Adjuvants, Immunologic/adverse effects , Adult , Aged , Animals , Antibodies, Monoclonal/adverse effects , BCG Vaccine/adverse effects , Drug Administration Schedule , Female , Hemocyanins/adverse effects , Humans , Immunization, Secondary , Immunoconjugates/adverse effects , Infusions, Intravenous , Injections, Intradermal , Male , Melanoma/immunology , Melanoma/surgery , Mice , Middle Aged
9.
Br J Radiol ; 69(826): 920-4, 1996 Oct.
Article in English | MEDLINE | ID: mdl-9038527

ABSTRACT

Various side effects have been associated with the clinical use of contrast media. Immunological mechanisms have been proposed but there have been very few experimental studies with animal models. We have attempted to develop murine models to determine whether or not anaphylactic antibodies such as IgE and IgG1 against hapten (DNP) were enhanced with contrast medium (iopamidol) as an adjuvant or if the contrast medium itself produced antibodies of the IgE class. The results showed that anti-hapten IgE and IgG1 production was greatly enhanced with immunogen plus contrast medium. Anti-contrast medium antibodies of the IgE class could not be detected by PCA reactions. The enhancement of IgE and IgG1 production for hapten was associated with IL-4 release by the neutralization test used by monoclonal anti-IL-4 antibodies. This is the first observation to show that contrast media may have a strong adjuvant effect for the production of IgE and IgG1. This murine model demonstrates a possible immunological function of contrast media in vivo.


Subject(s)
Anaphylaxis/immunology , Contrast Media , Immunoglobulin E/blood , Immunoglobulin G/blood , Iopamidol , Anaphylaxis/classification , Animals , Contrast Media/adverse effects , Disease Models, Animal , Enzyme-Linked Immunosorbent Assay , Female , Hemocyanins/adverse effects , Hemocyanins/immunology , Iopamidol/adverse effects , Mice , Mice, Inbred BALB C , Spleen/immunology
10.
Clin Exp Allergy ; 25(3): 252-9, 1995 Mar.
Article in English | MEDLINE | ID: mdl-7788573

ABSTRACT

In view of increasing evidence suggesting an active immunoregulatory role of the skin keratinocytes and the observation that the differentiation of allergen specific T lymphocytes is critical in the development of allergy, we evaluated epidermal expression of HLA-DR antigen in skin reactions induced with an atopen (house dust mite) and with an non-atopic antigen (Hemocyanin). Two groups of patients with house dust mite (Dermatophagoides pteronyssinus [Der p]) allergy were compared, one group was skin tested with Der p, the other group was immunized and subsequently skin tested with Helix pomatia Hemocyanin (HPH). Biopsy specimens taken at 48 h after the HPH (n = 11) and Der p (n = 11) tests were analysed immunohistologically. Reactions in both groups were comparable in size. Immunohistological analysis showed domination by CD4+ lymphocytes. Expression of HLA-DR antigen by epidermal keratinocytes was observed in six out of 11 of the HPH induced reactions, but in none of the Der p induced reactions. Eosinophils were spotted only throughout the Der p induced reactions, showing a good correlation with the number of CD4 positive lymphocytes. The lack of HLA-DR expression by keratinocytes during the allergen-induced reaction, compared with the Hemocyanin induced reaction can be the result of a difference in cytokine profile of the lymphocytes dominating the dermal infiltrate. On the other hand evidence exists that defective HLA-DR expression by keratinocytes enhances antigen induced lymphocyte activation, and may thus contribute to the development of allergen-specific T-lymphocytes.


Subject(s)
Dermatitis, Allergic Contact/metabolism , Glycoproteins/adverse effects , HLA-DR Antigens/biosynthesis , Hemocyanins/adverse effects , Hypersensitivity, Delayed/metabolism , Keratinocytes/metabolism , Allergens/adverse effects , Animals , Antigens, Dermatophagoides , CD4-Positive T-Lymphocytes/immunology , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/pathology , Eosinophils/immunology , Helix, Snails/immunology , Humans , Hypersensitivity, Delayed/etiology , Hypersensitivity, Delayed/pathology , Immunoenzyme Techniques , Immunophenotyping , Mites/immunology , Skin/metabolism , Skin/pathology , Skin Tests
11.
Urologe A ; 33(2): 138-43, 1994 Mar.
Article in German | MEDLINE | ID: mdl-8178408

ABSTRACT

A prospective randomized controlled study on the effect of KLH (keyhole limpet hemocyanin) versus etoglucid in the prevention of recurrences in primary and recurrent superficial transitional cell carcinoma of the bladder (stage pTa-pT1, grades 1-3 according to the recommendations of UICC and WHO) after complete transurethral resection of the tumor started in 198. Patients in group 1 (n = 76) were immunized with 1 mg KLH intracutaneously, after which they received bladder instillations of 30 mg (30 ml) KLH weekly for 6 weeks and then monthly for 1 year. Patients in group 2 (n = 85) received weekly bladder instillations of 0.565 g etoglucid (50 ml 1% solution) for 6 weeks and then monthly for 1 year. The percentage of recurrences, recurrence rate, disease-free interval and tumor progression rate were evaluated for both treatment groups. The end-point of the study was progression in stage or grade or more than two recurrences during the observation period. The shortest follow-up was 12 months, the mean follow-up, 27.5 months. No statistically significant differences were found between the two groups in percentage of recurrences (43.4% KLH-53.9% etoglucid), recurrence rate (4.4 KLH-3.9 etoglucid), mean disease-free interval (12.1 months KLH-13.6 months etoglucid) or progression rate (6.5% KLH-9.4% etoglucid).


Subject(s)
Adjuvants, Immunologic/administration & dosage , Carcinoma, Transitional Cell/therapy , Ethoglucid/administration & dosage , Hemocyanins/administration & dosage , Neoplasm Recurrence, Local/therapy , Urinary Bladder Neoplasms/therapy , Adjuvants, Immunologic/adverse effects , Administration, Intravesical , Adult , Aged , Aged, 80 and over , Carcinoma, Transitional Cell/pathology , Combined Modality Therapy , Ethoglucid/adverse effects , Female , Follow-Up Studies , Hemocyanins/adverse effects , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Prospective Studies , Urinary Bladder Neoplasms/pathology
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