Adjuvant immunotherapy of high risk stage I melanoma with transfer factor.

Following conventional surgical management, 100 patients with high risk Stage I melanoma were treated with transfer factor to reduce the incidence of disease recurrence. All patients had primary lesions invasive to Clark's level III or deeper and exceeding 1.0 mm in measured thickness. Ninety-six patients are available for analysis at 15 to 67 months (median: 30 months) after diagnosis. Nine patients have had a recurrence of disease (treatment failure), and one has died. Actuarial non-failure rate is 90%, and survival rate is 99% at five years. A nonrandomized but contemporary control group of 46 patients displaying comparable risk factors was treated with surgery alone. The non-failure rate of this group is 63%, and the survival rate is 69%, data consistent with the results of several published studies. These results suggest that transfer factor immunotherapy may be a valuable adjunct in the treatment of patients with high risk Stage I melanoma.

Pulmonary hyalinizing granulomas in a patient with malignant lymphoma, with development nine years later of multiple myeloma and systemic amyloidosis.

In our patient, multiple bilateral nodular pulmonary densities appeared on a chest x-ray at the time of diagnosis of stage IV diffuse lymphocytic lymphoma. After localized radiation therapy, the patient received no further systemic therapy. The pulmonary nodules slowly became larger and more numerous. Nine years later the patient developed proven multiple myeloma. Pulmonary hyalinizing granulomas have not heretofore been associated with proven lymphoreticular neoplasia, although this has long been suspected. The occurrence of two B-cell tumors at different points in time associated with systemic amyloidosis is an extremely rare event. The authors discuss the possibility that these conditions represent an abnormality in a common cell of origin with differing expression over time. Coincidence, however, remains a likely explanation for the different immunopathies that occurred in our patient.

On the number and nature of antigen-sensitive lymphocytes in the blood of delayed-hypersensitive human donors.

The virus plaque assay has been successfully employed to enumerate antigen-sensitive cells in the peripheral blood lymphocyte populations of tuberculin-hypersensitive human donors. The method is based on the finding that, while resting lymphocytes are unable to produce a variety of viruses upon infection, lymphocytes activated by specific antigens become capable of virus replication. The average number of antigen-sensitive cells detected in cell populations from donors reacting to first test strength or intermediate test strength tuberculin was approximately 3.6/1000 lymphocytes, and the averages for both groups were similar. Studies on the kinetics of appearance of these virus plaque-forming cells and on the effects of the mitotic inhibitor, vinblastine, indicate that the activation of these antigen-sensitive cells is a linear process and that the cells must be nondividing cells during this process. These qualities contrast markedly with those described for the mitogenic response and the antibody-producing cells which require cell division and increase exponentially. On the basis of these experiments it is suggested that the antigen-sensitive cell measured in the virus plaque assay is the effector cell in delayed-type hypersensitivity reactions and, in addition, may be one of the cells critically involved in antibody formation.