Interleukin-11 administration normalizes the platelet count in a hypersplenic cirrhotic patient.

We report the successful administration of interleukin-11 (IL-11 or oprelvekin), a promoter of megakaryocyte maturation, to a 54-year-old male Jehovah's Witness with hepatic cirrhosis and hypersplenic thrombocytopenia requiring surgery for symptomatic interstitial cystitis. This observation suggests that oprelvekin might be crucial in the acute management of certain types of hypersplenic thrombocytopenias.

Octreotide acetate therapy for hypercalcemia complicating small cell carcinoma of the lung.

I have reported a rare case of hypercalcemia associated with small cell carcinoma of the lung. Our patient initially had small cell carcinoma of the right bronchial orifice, with metastases to the mediastinum and the lumbar vertebrae. Complete remission was achieved with chemotherapy over the next 3 years, but then three metastatic foci were found in the brain. Subsequently, recurrent small cell carcinoma was identified in the lung, and chemotherapy was resumed. The patient's condition deteriorated over the following 2 months. When intravenous saline failed to control hypercalcemia, octreotide acetate was given. The serum calcium level returned to normal and remained stable, without any other intervention, until the day after octreotide therapy was discontinued. I have discussed hypercalcemia due to bronchogenic carcinoma in terms of incidence in relation to histologic type, mechanisms of pathogenesis, and current treatment methods.

Biochemical modulation of combined radiation and 5-fluorouracil treatment of murine tumors by d,l-leucovorin.

Experiments were designed to establish whether the response of the Lewis lung tumor (LLca) to combined 5-Fluorouracil (5-FU) and radiation could be enhanced by the addition of the reduced folate leucovorin (LV) to the treatment protocol. Twenty-four hr after the tumors received a single dose of from 2.0 to 8.0 Gy of X-rays, the tumor-bearing animals were treated with a 5 day schedule of 10 mg/kg LV + 30 mg/kg 5-flourouracil (q 24 hr) in which LV preceded the 5-FU by 60 minutes. Under these time/dose configurations, no evidence of treatment-limiting gastrointestinal or hematopoietic toxicity was observed with the LV + 5-FU treatment. Following radiotherapy alone, tumor growth delays (TGDs) ranging from 1 to 6.5 days were observed with X-ray doses of from 2.0 to 8.0 Gy, respectively. When the radiotherapy was followed by the administration of 5-FU (q24 hr x 5) alone, a modest increase in the tumor response was observed; TGD increased from 1.0 to 2.0 days with 2.0 Gy and from 6.5 to 8.5 days with 8.0 Gy of X-rays. The addition of LV to the 5-FU schedule, however, resulted in a significant enhancement of the response of the tumor to the combined radiation + 5-FU treatment. TGDs increased from 1.0 to 8.0 days with a radiation dose of 2.0 Gy and from 6.5 to 34.5 days with a dose of 8.0 Gy. When administered as single agents, 5-FU and 2.0 Gy resulted in only a modest response by the LLca tumor (TGDs = 1.0 day), while LV had no effect on tumor growth. These observations, therefore, suggest that biochemical modulation of 5-FU by LV can be realized in vivo and that this biochemical modulation may be valuable in more conventional clinical schedules using combined radiation and 5-FU treatment.