Synergy between interleukin-2 and prothymosin alpha for the increased generation of cytotoxic T lymphocytes against autologous human carcinomas.

Peripheral blood mononuclear cells (PBMC) from cancer patients were cultured in vitro with irradiated autologous tumor cells isolated from malignant effusions (mixed lymphocyte tumor cultures, MLTC) and low-dose (50 IU/ml) recombinant interleukin-2 (IL-2). The combination of IL-2 and prothymosin alpha (ProTalpha) resulted in a greater PBMC-induced response to the autologous tumor than that brought about by IL-2 alone. In particular, ProTalpha specifically enhanced the CD4+ T-cell-mediated proliferation against the autologous tumor. CD4+ T cells seemed to recognize tumor antigens presented by HLA-DR molecules expressed on the autologous monocytes, since preincubation of the latter with an anti-HLA-DR monoclonal antibody (mAb) abrogated the response. In addition, MLTC set up with IL-2 and ProTalpha also generated more MHC-class-I-restricted cytotoxic T lymphocytes (CTL) against the autologous tumor than did MLTC set up with IL-2 alone. The MLTC-induced CTL contained high levels of cytoplasmic perforin and their development was strictly dependent on the presence of both autologous CD4+ T cells and monocytes. In the absence of either population there was a strong impairment of both proliferative and cytotoxic responses which was not restored by the presence of ProTalpha. In contrast, when both cell populations were present, ProTalpha exerted optimal enhancement of CD4+ T cell proliferation, which was associated with potentiated CTL responses. Our data emphasize the role of ProTalpha for the enhancement of IL-2-induced CTL responses against autologous tumor cells. Such responses require collaborative interactions between CD4+, CD8+ T cells and monocytes as antigen-presenting cells. Our data are relevant for adoptive immunotherapeutic settings utilizing IL-2 and ProTalpha-induced autologous-tumor-specific CTL.

Laryngeal squamous cell carcinoma with sebaceous differentiation.

A case of supraglottic laryngeal squamous cell carcinoma with sebaceous differentiation in a 68-year-old Caucasian male is described. A right cervical lymph node metastasis, excised during the laryngectomy operation, consisted exclusively of squamous cells. Despite intensive post-operative chemotherapy, the patient developed metastatic foci in the left cervical area and left pulmonary hilus and died seven months later. This is the second case report of a laryngeal squamous cell carcinoma with sebaceous differentiation in the literature.

Laryngeal preservation in cases of advanced laryngeal cancer treated with platinum based induction chemotherapy before local treatment.

In this study we analyse our preliminary results after treating 28 patients with locally advanced laryngeal cancer with platinum based induction chemotherapy followed by radiation therapy or surgery. The median age of our patients was 60 (46-75) years and median performance status was 80 (60-100). In 18 of the 28 patients locoregional treatment was radiation therapy with an overall response of 94.4 per cent. After a median follow-up of 26 (15-40) months 39.3 per cent of the whole group of patients are alive and disease-free and six (21.4 per cent) patients are alive and disease-free preserving their larynx. We conclude that although more extensive studies with large groups of patients and longer follow-up is needed to reach definite conclusions, it seems that platinum based induction chemotherapy can be used successfully in locally advanced laryngeal cancer followed by radiotherapy. In those cases who respond well, the patient's larynx is preserved without compromizing the overall survival.

[Spheno-ethmoidectomy in recurrent nasal polyposis. Technic, indications, results]. / La sphéno-ethmoïdectomie dans la polypose nasale récidivante. Technique, indications, résultats.

Spheno-ethmoidectomy can be legitimately included within the therapeutic schema for nasosinusal polyposis causing incapacity and resistant to medical treatment. Benefiting from recent technical progress, a very precise medical therapeutic framework and improved knowledge of ethmoid surgical anatomy, a marked reduction in complications of this operation has been observed. Results of a series of 175 ethmoidectomies performed in 90 patients confirm the good results reported in the literature, even though follow up is still insufficient.

[Cholesteatomas of the fronto-orbital region]. / Les cholestéatomes de la région fronto-orbitaire.

Three cases of primary fronto-orbital cholesteatoma are reported and the relevant ORL and neurosurgical literature reviewed. Clinical diagnosis of this rare affection is not simple but is suggested by signs of infero-internal exophthalmus, an external orbital mass or exteriorized sinusitis after chronic headache. Two characteristic features are seen on radiology. The essential therapeutic problem is to prevent late recurrences, their frequency appearing to have been underestimated. Secondary cholesteatoma of iatrogenic or post-traumatic development is seen more rarely, and produces an endosinus disease treated surgically through a conventional para-lateronasal approach. Primary cholesteatoma, the more common variety, originates in the frontal diploë, is perisinusal in location and can extend into neighboring structures, particularly the external orbital apophysis. A CT Scan is essential in order to detect endocrine extension. A surgical approach adapted to the perisinusal localization of the lesion must be adopted, as for example the Cairns-Unterberger approach.