Adjuvant chemotherapy in colorectal cancer.

UNLABELLED: Our aim was to study the three-fold response to treatment, survival rates and toxicity. MATERIALS AND METHODS: We review 76 patients (median age 66.2 years) affected with the disease. All received adjuvant chemotherapy, while 13 with rectal cancer were subjected to radiation too. Patients were staged after Duke's classification. RESULTS: Recurrence was noted in 15 patients, 3 at stage B and 12 at stage C; median recurrence-free interval was 18.9 months. Patients without relapse had a median disease-free period of 35.9 months. Median overall survival was 35.21 months. The 5-year survival mark have surpassed 14 patients (3 with recurrent disease): 8 at stage B and 6 at stage C. Ten have died; median survival in these patients was 30.5 months. No patients suffered from severe bone marrow toxicity; mucositis and diarrhoea grade III/IV was noted in 10 patients.

Obesity and colorectal cancer.

BACKGROUND: To correlate obesity and colorectal cancer for Greek living conditions. PATIENTS AND METHODS: We studied 97 patients, who over the last 5 years were diagnosed histopathologically with colorectal cancer. 75.3% of the patients were either overweight or centrally obese; secondly, 21.6% patients had diabetes, percentages higher than those in the population (statistically significant). Hyperinsulinaemia and resistance to insulin have been implicated in colorectal carcinogenesis. CONCLUSIONS: As our sample was small, no statistically significant evidence correlating diet and/or physical activity to colorectal cancer has emerged.

alpha-Interferon therapy in patients with chronic active hepatitis B: immunological profile.

The effect of interferon-alpha 2b (IFN) on viral markers, liver function and immunological parameters (CD3, CD4, CD8, B, NK, II-2 receptor and HLA-DR positive cells in blood and T cell proliferation) was studied in 9 patients with HBsAg(+), HBeAg(-) chronic active hepatitis (CAH). Three patients were HBV-DNA(+) and 6 also had complications of cirrhosis of the liver (LC). IFN was given at a dose of 2.5 mil IU x 3 weekly for 6 months. One patient with LC developed hepatic coma and died 2 months later. Severe leukopenia limited duration of treatment to 2 and 4 months in another 2 patients. By the end of treatment, the 8 patients were in good clinical status, SGOT, SGPT levels and prothrombin time were decreased, HBV-DNA became negative in 2 out of 3 patients and proportions of CD3, CD4, B, NK and activated cells were significantly decreased. When compared to controls, NK and activated cells were significantly increased in patients before and were gradually decreased by the end of treatment. In contrast, T transformed cells were significantly decreased before and ranged in normal levels by the end of treatment. These findings suggest that immunomodulatory activity possibly contributes to the beneficial effect of IFN therapy.

Possible mechanisms underlying peripheral lymphocyte activation in chronic liver disease and asymptomatic HBsAg carriers.

Proportions of T lymphocyte subsets (OKT3, OKT4, OKT8) and expression of interleukin-2 (IL-2), transferrin (TFR) receptors and HLA-DR antigens were studied in the peripheral blood of 21 healthy HBsAg carriers, 10 patients with chronic active hepatitis B (CAH), 10 patients with alcoholic liver cirrhosis (ALC) and 10 subjects with negative markers of previous hepatitis B virus (HBV) infection. T lymphocyte subsets ranged within normal levels in CAH and carriers, whereas a significant decrease of OKT4 was noted in ALC possibly involved in the pathogenesis of this disorder. Significantly elevated numbers of activated cells (cells expressing IL-2, TFR receptors and HLA-DR antigens) were observed in all three groups. A significant increase in OKT8 cells within the TFR population was noted in CAH and ALC, whereas proportions of T subsets in the TFR population were normal in carriers. These findings possibly suggest a common pathogenetic mechanism in the activation of lymphocytes in CAH and ALC leading to liver damage and an immune response against HBV in healthy carriers.

In vitro effect of interferon alpha-2b on T lymphocyte transformation and leukocyte migration inhibition in patients with chronic brucellosis.

The in vitro effect of IFN-a on lymphocyte transformation and specific immune response against Brucella antigens was studied in 33 patients with chronic brucellosis and 10 normal controls. The following immunologic in vitro tests were applied: PHA activated lymphocyte transformation test using Bromodeoxyuridine and a monoclonal antibody in the presence and absence of 50 and 100 IU IFN Alpha-2b and leukocyte migration inhibition test against Brucella antigens in the presence and absence of 100 and 500 IU of IFN Alpha-2b. Patients were further divided to 2 subgroups according to a positive or negative migration inhibition test. Our results showed that T lymphocyte transformation was similar in patients and controls and that the addition of 50 IU IFN resulted in a significant increase of transforming cells whereas in the concentration of 100 IU IFN only anergic patients and controls responded positively. IFN also resulted in a significant leukocyte migration inhibition only in anergic patients and controls. These findings suggest that the chronic infection is not due to a generalized cellular immunodeficiency state and that IFN Alpha-2b might be a promising therapeutic approach in anergic patients.