RESUMEN
Paraneoplastic cerebellar degeneration (PCD) is a rare nonmetastatic neurological complication in cancer patients. Anti-Yo is one of the anti-onconeural antibodies found in PCD patients. It is believed that anti-Yo occurs almost always in women and is most likely associated with gynecologic or breast cancers, although exceptions exist. Here we report a PCD patient with ovarian cancer having high-titer anti-Yo. The acute onset of her PCD symptoms mimicked that of a stroke. Her ovarian cancer tissue contained abundant plasma cells and lymphocytes. After a thorough review of the literature, we propose a schematic hypothesis for the autoimmune pathogenesis of PCD. Despite anecdotal case reports of neurological improvement with different combinations of treatment, including IVIg, there is still no definitely effective treatment for PCD. Further research on the pathogenesis of PCD may lead to more effective therapies.
Asunto(s)
Autoantígenos/sangre , Cistadenocarcinoma Seroso/sangre , Cistadenocarcinoma Seroso/diagnóstico , Proteínas de Unión al ADN/sangre , Proteínas de Neoplasias/sangre , Proteínas del Tejido Nervioso , Neoplasias Ováricas/sangre , Neoplasias Ováricas/diagnóstico , Degeneración Cerebelosa Paraneoplásica/sangre , Degeneración Cerebelosa Paraneoplásica/diagnóstico , Anciano , Femenino , HumanosRESUMEN
Seventy-nine patients with metastatic melanoma received chlorozotocin (150 mg/m2) every 6 weeks. Two complete and five partial responses were observed: 18% in patients who had not previously received chemotherapy and 6% in previously drug-resistant patients. Dose-limiting toxic effects were vomiting and myelosuppression.
Asunto(s)
Melanoma/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Estreptozocina/análogos & derivados , Evaluación de Medicamentos , Humanos , Leucopenia/inducido químicamente , Metástasis de la Neoplasia , Estreptozocina/efectos adversos , Estreptozocina/uso terapéutico , Trombocitopenia/inducido químicamente , Vómitos/inducido químicamenteAsunto(s)
Altretamina/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Mitolactol/uso terapéutico , Triazinas/uso terapéutico , Adulto , Anciano , Altretamina/efectos adversos , Ensayos Clínicos como Asunto , Evaluación de Medicamentos , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mitolactol/efectos adversos , Metástasis de la Neoplasia , Factores de TiempoAsunto(s)
Carcinoma Broncogénico/complicaciones , Neoplasias Pulmonares/complicaciones , Vena Cava Superior , Adulto , Anciano , Antineoplásicos/uso terapéutico , Carcinoma de Células Pequeñas/complicaciones , Carcinoma de Células Escamosas/complicaciones , Niño , Preescolar , Urgencias Médicas , Femenino , Humanos , Linfoma/complicaciones , Masculino , Persona de Mediana Edad , Dosificación Radioterapéutica , Recurrencia , Síndrome , Factores de Tiempo , Enfermedades Vasculares/diagnóstico , Enfermedades Vasculares/etiología , Enfermedades Vasculares/terapiaRESUMEN
To characterize the immunogenicity of influenza vaccine in patients with malignant disease, 21 patients with lymphoreticular neoplasms and 21 patients with solid tumors were immunized with inactivated influenza A/New Jersey/76 whole virus vaccine. The patients were randomized with respect to time of vaccine administration in relation to administration of chemotherapy. Fourfold or greater antibody titer increases occurred in 94% of controls and 71% of cancer patients (P less than 0.05), and the magnitude of antibody response was also significantly lower in cancer patients (P less than 0.01). There was no correlation of antibody responsiveness with sex, age, tumor type, absolute lymphocyte count, disease status, or type of chemotherapeutic agent used. Fifty percent of patients immunized at the time of chemotherapy administration showed seroconversion, which is significantly less than the 93% response rate observed in patients immunized between chemotherapy courses. It is thus recommended that individuals with malignant disease should receive influenza immunization between chemotherapy courses.