Patients and Methods Patients and treatmentPatients with malignant cancer confirmed histologically at antecedent treatment underwent adoptive immuno-cell therapy at Meditopia Numazu Clinic between November 2007 and November 2010.Written informed consent was obtained from all patients before the start of immuno-cell therapy.The clinical data of 38 consecutive patients (18 men, 20 women; mean age, 64 years; age range 39-83 years) were evaluated.The Eastern Cooperative Oncology Group (ECOG) performance status [1] at the beginning of the treatment was PS-0 in 18 patients, PS-1 in 17, PS-2 in 2, and PS-3 in 2. All patients underwent at least one course of treatment consisting of 6 infusions of ALs (3-10 x 109) and/or matured DCs (1-10 9x106) intravenously or sub-cutaneously at intervals of around 2 weeks.The patients also received additional conventional
The surgical cure rate for breast cancer is relatively high among the various cancers thanks to recent advances in perioperative hormonal therapy and chemotherapy.However, the 10-year survival rate for stage 4 breast cancer is only 16% in Japan.Here we report a case of 25-year survival following primary right radical mastectomy with axillary lymph node dissection at age 46 years (in 1996) and subsequent immunotherapy and chemotherapy.Pathological diagnosis was stage 3A (T3aN2M0), and histochemical diagnosis was estrogen receptor(-), progesterone receptor(+), HER2(+).During postoperative year 1 (POY1), chemotherapy and focal radiation therapy were added for a solitary metastatic lesion to a right cervical lymph node.Continuous chemotherapy for HER2(+) metastatic breast cancer (MBC) was performed for 8 years.In POY8, side effects of chemotherapy became intolerable, tumor marker levels increased, and lymphodepletion developed.Following immune cell therapy with activated T lymphocytes (ATL)she recovered completely with no adverse events for the next 10 years.In POY18, a second, massive administration of ATL was required because of right-sided malignant pleural effusion.She recovered again to ECOG performance status(PS) 0 at 1 year after the immunotherapy combined with chemotherapy.Twenty-five years after initial surgery, the patient continues to be well.We discuss several important factors for predicting the effectiveness of immune cell therapy combined with chemotherapy during long-term follow-up.The most important are lymphodepletion and trends in the CD4/CD8 ratio, and other considerations are the effectiveness of the chemotherapeutic agents combined with immune cell therapy, tumor markers, and ECOG PS.
A 57-year-old woman admitted to our hospital in October, 1988 because of the tumor of the abdominal wall and abnormal shadows of right chest wall and right upper mediastinum. Her esophagus had been resected and reconstructed by the stomach roll because of the esophageal leiomyosarcoma in May, 1976. Clinical examinations revealed that the abdominal mass and chest shadows were the recurrence of the leiomyosarcoma. The abdominal tumor was resected on 17th October, 1988. On 14th December, 1988 right thoracotomy was performed. Chest wall tumor (40 x 30 x 20 mm) and mediastinal tumor (45 x 40 x 35 mm) were resected completely. The mediastinal tumor was adhered to the remnant esophageal muscle layer. Microscopic section of the tumor showed spindle cell sarcoma with fine calcification, and it was diagnosed as the metastatic leiomyosarcoma.
Hemodynamic and angiocardiographic studies were performed in postoperative patients with tetralogy of Fallot. Pressure gradient between the right ventricle and pulmonary artery was correlated with the narrowest area in the pulmonary arterial pathway. Regurgitant fraction was also correlated with regurgitant area which was determined by preoperative area of the pulmonic annulus and width of the outflow patch. Follow-up study of postoperative patients with tetralogy indicated that those with pressure gradient less than 20 mmHg and regurgitant fraction less than 15% could be considered ideally corrected. A table was constructed for determining the most appropriate width of the outflow patch for the ideal correction.
