Cancer Research and Treatment

Retroviral Vector - mediated Tumor Necrosis Factor - α Gene Transfer into Human Gastric Carcinoma Cell Lines: Jung Ae Rhee, Jung Ae Lee, Dae Seog Heo, Sung Koo Han, Noe Kyeong Kim; J Korean Cancer Assoc. 1994;26(5):677-688.

Abstract PDF: The tumor necrosis factor a (TNF-a) is a potent cytokine with antitumor activities including a direct cytotoxic effect on human cancer cells and the enhancement of a cytotoxic immune response against the tumor. However, its effectiveness in the human clinical trials is limited due to severe systemic toxicities. An alternative approach, that tumor cells are genetically engineered to secrete TNF-a locally to stimulate the immune system without systemic toxicities, is suggested as a form of gene therapy (tumor-cell-targeted lymphokine gene therapy). In this trial, cDNA encoding human TNF-a (TNF-NeoR) was introduced into five human gastric carcinoma cell lines using a retroviral vector to examine whether TNF-a gene could be transfected and expressed in gastric carcinoma cell lines in vitro. Successful transfer of TNF-a gene into five gastric csrcinoma cell lines was confirmed by polymerase chain reaction techniques. Supernatants (1: 2 dilution) from cultures of transduced gastric carcinoma cell lines demonstrated cytotoxicity to TNF-sensitive WEHI 164 cell lines in the range of 20-49%. TNF- transduced gastric carcinoma cell lines secreted TNF-a at the concetration of 479-8869 pg/10(6) cells-24 hours, whereas the parental cell lines did not secrete TNF-a. There were no differences in the growth rates between parental and TNF-transduced cell lines in vitro. The four TNF-transduced SNU cell lines showed the resistance to endogenous and exogenous TNF, except SNU-668 cell line. In conclusion, TNF-a gene was successfully transfected and expressed in gastric carcinoma cell lines in vitro. These data will be helpful in the development of tumor-cell-targeted lymphokine gene therapy for the treatment of advanced gastric carcinoma.

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Molecular Characteristics of Tumorigenesis in Human Gastric Carcinomas: In Ho Kim, Joong Shin Kang, Min Ho Suh, Soo Sang Sohn, Suk Kon Kim, Won Ki Baek, Seong Il Suh; J Korean Cancer Assoc. 1994;26(5):688-702.

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Prognostic Significance of p53 Overexpression in Gastric Carcinoma: Yong Il Kim, Jin Pok Kim, Woo Ho Kim, Sang Yong Song, Chong Jai Kim; J Korean Cancer Assoc. 1994;26(5):702-711.

Abstract PDF: The overexpession of p53 protein was immunohistochemically studied in a total of 92 gastric carcinomas, of which 40 cases(43.5%) showed nuclear immunoreactivity. Older age(p<0.001), lymph node metastasis(p<0.05), stage(p<0.05), and higher expression of proliferating cell nuclear antigen(p<0.05) were correlated with p53 overexpression. Other clinicopathologic parameters including sex, tumor site, WHO classification, Ming classification, inflammation degree, desmoplasia degree, tumor invasion depth, gross type, size, and recurrence were not related with p53 overexpression. However, intestinal type(56.3%) by Lauren classification and advanced gastric carcinoma(48.0%) showed higher incidence of p53 overexpression than diffuse type(36.7%) and early gastric carcinoma(23.5%), respectively(0.05< p<0.1). Lifetest showed that p53 overexpression was not related with patients survival, although tumor site, size, depth of invasion, stage, lymph node metastasis, and recurrence were closely correlated with patients survivaL We concluded that p53 overexpression was a common event in gastric carcinogenesis and may play a role not in late, invasive stage of tumor progression related with patient survival, but in early, proliferative stage of gastric carcioma progression.

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Clinical Analysis and Prognosis According to the Histopathologic Type of Advanced Gastric Cancer: Sung Ha Moon, Hyun Uk Shin, Jung Weon Shim, Hae Kyung Ahn, Kyung Suk Chung; J Korean Cancer Assoc. 1994;26(5):711-722.

Abstract PDF: The prognostic significance of histologic ciassifications in patients with advanced gastric cancer has been controversiaL The purpose of this study was to clarify clinical characteristics according to the Lauren's and Ming's classifications and to assess the implication of both classifications as a prognostic factor in advanced gastric cancer. The clinical characteristics accordin& to the histologic classifications were evaluated in 238 patients with advanced gastric cancer who underwent gastrectomy between 1984 and 1993. The authors also investigated whether the Lauren's and Ming's classifications represent a prognostic parameter by log-rank test and Cox proportional hazards models. Two hundred thirty eight patients were classified as intestinal (ll4/238, 48%), diffuse (111/ 238, 47%), and mixed(13/238, 5%), according to Lauren; and as expanding(112/238, 47%) and infiltrative (126/238, 53%), according to Ming. Carcinomas of intestinal type (n= 114) were mostly expanding type (n=101), and carcinomas of diffuse type (n= 111) were mostly infiltrative type (n=105). The percentages of diffuse or in- filtrative type with young age, Borrmann type III or IV, poorly differentiation, and T3-T4 inva- sion were significantly greater than those of intestinal or expanding type, respectively, but no significant differences in types of Laurens or Mings classifications were found with regard to the tumor size, regional 1ymph node metastasis and distant metastasis. The 5-year survival rate of patients with intestinal type (51.4%) was higher than those of patients with mixed type (45.8%) or diffuse type (30.5%). The 5-year survival rate of patient with expanding type (53.9%) was higher than that of patients with infiltrative type(29.6%). Multivariate analysis by Cox proportional hazards models revealed that primary tumor(T), Borrmann type, Lauren's classification, and regional lymph node(N) were significant prognostic factors. These results suggest that there are similarities between Lauren's and Ming's classification in regard of age or sex distribution, Borrmann type, tumor invasion, histologic differentiation, and 5-year survival rate. The combination of WHO histologic type with Lauren's and Mings classifications may provide a fairly complete picture of gastric cancer for prognostic purpose.

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A Study of Estrogen Receptors in Gastric Cancer: Young Jin Kim, Moon Oh Bae, Shin Kon Kim; J Korean Cancer Assoc. 1994;26(5):722-728.

Abstract PDF: Recently the presence of estrogen receptor(ER) has been demonstrated in some cases of cancer of the digestive tract such as stomach, large intestine, pancreas and the liver which are non-target organs of sex hormones. The authors studied ER in tumors from 95 gastric adenocarcinomas using immunohisto- chemical staining with monoclonal antibody. DNA ploidy using flow cytometry was also as- sessed in 75 cases of gastric carcinomas. ER positivity was 40 of 95(42.1%) gastric carcinomas. The tendency of receptor positivity increased with progression of tumor and lower differentiation. There was no positive relationship between ER positivity and sex, age, gross type, DNA ploidy and the level of carcinoem- bryonic antigen. The results of this study show that hormonal factors are involved in gastric carcinomas and that the cancers have endocrinic characteristics. The sturdies clarifying the rofe of hormones to cancer cells will be valuable in the design of hormonal therapy.

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Prediction of Lymph Node Metastasis in Early Gastric Cancer: Wan Sik Yu, Il Woo Whang, Jong Hoon Park; J Korean Cancer Assoc. 1994;26(5):728-735.

Abstract PDF: The frequency of lymph node metastasis according to sex, age, presence or absence of clinical symptoms, duration of symptoms, location and size of tumor, gross and histologic type, and depth of invasion was analysed in 269 patients with early gastric cancer who were surgically treated at the Department of Surgery, Kyungpook National University between 1982 and 1993. Metastases were present in the dissected lymph nodes of 24 patients(8.9%). Among nine factors, size of tumor(p=0.002) and depth of invasion(p=0.010) correlated significantly with node involvement. Other seven factors revealed not statistically significant differences. Univariate analysis showed significant differences in five year survival rates(82.9% vs. 94.0%) and ten year survival rates(82.9% vs. 90.6%) between patients with and without lymph node metastases(p = 0.022). Tumors which satisfy the following criteria may not metastasize to lymph nodes: (1) confined to the mucosa: (2) less than 2 cm in diameter; (3) macroscopic type I, IIa and IIb. It can be concluded that early gastric cancer which satisfies above criteria can be treated by minimal local procedures such as endoscopic treatment or laparoscopic wedge resection.

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p53 Mutations in Metachronous Upper Aerodigestive Tract Cancers: Han Kwang Yang, Michael J . Kelley; J Korean Cancer Assoc. 1994;26(5):735-746.

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The Significance of c-erbB-2 Oncoprotein as a Prognostic Factor in Human Breast Cancer: Sung Jun Park, Hwa Bong Doh; J Korean Cancer Assoc. 1994;26(5):746-756.

Abstract PDF: Prognostic factors help the clinician by providing information on the likely site of initial recurrence, predicting survival time after dignosis, the clinical course after relapse has occured, and the expected response to medical therapy. In order to investigate the prognostic significance of c-erbB-2 overexpression, sections of for- malin-fixed, paraffin-embeded tissue from 60 primary breast cancers were stained immunohistochemically against the c-erbB-2 oncoprotein.Positive reaction indicative of c- erbB-2 overexpression was observed on tumor cells in 25 (41.1%) samples. The overexpression of c-erbB-2 oncoprotein was not correlated with tumor size, lymph node involvement, estrogen and progesteron receptor status, epidermal growth factor receptor (EGFR) status, histologic type, menopausal status, but significantly correlated with nuclear grade. Overexpression of c-erbB-2 protein was more common among tumors of poor nuclear grade(grade 1)-16%-than those of good nuclear grade (grade 3)-25%-according to Blacks nuclear grading system. Postoperative clinical survey demonstrated a high tendency of recurrence rate and shorter survival time of patients with positive staining tumors as compared with those with negative staining tumors to overexpression of c-erbB-2 oncoprotein. In conclusion, these data suggest that the overexpressian of c-erbB-2 oncoprotein may be valuable for the prediction of biologically high malignant potential and the detection of c- erbB-2 oncoprotein in tumor section may have prognostic value in human breast cancer.

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Quantitation of AgNORs in Breast Lesions Using Image Analysis: In Sun Kim, Young Sik Kim, Aeree Kim; J Korean Cancer Assoc. 1994;26(5):756-764.

Abstract PDF: The argyrophilic nucleolar organizer regions(AgNORs) staining is one of the useful methods for the estimation of proliferative activity in conventional histologic sections in various benign and malignant lesions. Because of difficulties in AgNORs counting, there is a relucance to accept the technique as a reliable diagnostic tooL We measured the area and numbers of ARNORs in 22 surgically resected infiltrating ductal carcinomas and 5 fibroadenomas using image analyzer and also visually enumerated the numbers at x 1000 magnification. The number of AgNORs by visual conuting was correlated with the area measured by Image counting(r=0.56). The mean area of AgNORs in the malignant group(4.36um(2)) was significantly different(p<0.0001) from that of the benikn group(0.79pm). As the number of AgNORs increased, the area increased(r=0.7091 The result of this study suggests that measurement using image analyzer can give more objective and reproduccible measurement of ARNORs than visual counting.

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p53 Expression in Breast Cancer - Comparison between primary and metastatic lesions -: Young Bae Kim, Ja June Jang, Kyung Ja Cho, Joon Mee Kim, Young Chae Chu, Tae Sook Hwang; J Korean Cancer Assoc. 1994;26(5):764-770.

Abstract PDF: Accumulation of mutated p53 rotein in paired primary breast cancers and their metastatic axillary lymph node lesians are evaluated by immunohistochemical method to compare the difference between primary and metastatic foci. Among 75 cases, 19 cases showed increased p53 expression and 1 case showed decreased expression in metastatic foci campared to the primary foci. This nuclear protein was expressed only in the nuclei of the neoplastic cells except for one case which showed positive reaction in the nuclei of the hyperplastic ductal epithelium. This oncoprotein was expressed heterogenously in both primary and metastatic foci and appeared to be distributed more prominently in the invasive margins. We concluded: l) mutated p53 protein expression is heterogenously distributed 2) this mutated p53 protein expression was more frequent and increased in metastatic foci than primary foci 3) p53 gene mutation may be involved in breast cancer progression and evalution of metastatic subclone.

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Expressions of Blood Group Antigen A in Lung Cancer: Pyo Seong Han, Suk Chul Hong, Jong Jin Lee, Hai Jung Cho, Ae Kyung Kim, Ju Ock Kim, Sun Young Kim; J Korean Cancer Assoc. 1994;26(5):770-778.

Abstract PDF: Background
Blood group anti#gens A, B, and H, identical with those present in erythrocytes, are also found in some normal tissues. The expression of blood group antigens allows the identification of residual pneumocytes inside the tumor and the proper classification of some neoplasms. Variability of blood group antigen expression among tumor cells is a potentially useful indicator of functional tumor cell heterogeneity or progression. We evaluated the prognostic value of expression of blood group antigen A as a prognostic factors. Method: This study analyzed the expressions and losses of blood group antigen A in lung cancer patients with blood type A or AB. The presence of blood-group antigens was assessed immunohistochemically in paraffin-embedded tumor samples from 30 patients who underwent curative surgery, bronchoscopic biopy, percutaneous needle biopsy, lymph node biopsy for diagnosis of lung cancer from 1991 through 1994. Results; 1) The expression of blood group isoantigen A was observed in 15 cases (50%) 2) The expression of blaod group isoantigen A was observed in 64% of stage II, 47% of stage III, 25% of stage IV. 3) The expression of blood group isoantigen A was observed in 0% of large cell carcinoma, 17 % of small cell carcinoma, 63% of squamous cell carcinoma, 50% of adenocarcinoma, 100% of bronchioloalveolar cell carcinoma. 4) The losses of blood group isoantigen A were observed in 67% of patient who survived below 1 year, 44% of patients who survived 1 to 2 years, but no loss of expression were observed in patients who survived more than 2 years. 5) The median survival times of expressed group and lossed group of isoantigen A were 16.0, 9.8 months, respetively. 6) The loss of blood group antigen A was higher in patients who had metastatic lymph nade than in patients who had not. Conclusion: the expression of blood group antigen A in cancer cells is important favorable prognostic factor in patients with lung cancer.

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Concomitant Boost Radiotherapy in Clinical Study 3 Non - Small Cell Lung Cancer: Chan Il Park, Kyung Hwan Shin; J Korean Cancer Assoc. 1994;26(5):778-786.

Abstract PDF: A single treatement arm, phase I/II trial was performed to determine the tumor response to concomitant boost radiotherapy and to assess the toxic effects of this techneque in patients with stage III NSCLC. Between 1991-1992, 52 patients with stage III NSCLC were treated according to the concomi- tant boost technique. The large fields including primary mass and mediastinum received a dose of 54Gy in 30 daiiy fractions. The boost dose(13 Gy) was administered concomitantly with the last ten fractions of the large fields treatment, with a 6 haur intervaL The maximal allowed dose to the spinal cord was 45 Gy. At a median follow-up of 13 months, complete remission was achieved in 15 patients(28.8%) and a partial remission in 28 aptients(53.8%). The overall survival rate at 2 year was 19.9%. The median survival time was 13 months. The survival rates were 28% and 16% for the complete responders and partial/non responders. Grade 1 and 2 esophagitis occurred in 86.5% and 13.5% of the patients, respectively. The clinical or radiologic condition of 38 patients (73.1%) was compatible with radiation pneumonitis but no patients showed severe symptoms. Late complications have been limited to radiologically detected lung fibrosis in 12(23.1%) patients. The results so far appeared to be better than the outcome of conventional radiotherapy. Its real value will be determined in a prospective randomized study.

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A Randomized Comparison of EP Sequential Chemotherapy Versus EP / CAV Alternating Chemotherapy for Extencive - stage Small - cell Lung Cancer: Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim, Young Suk Park, Chang In Suh, Ki Suck Chang; J Korean Cancer Assoc. 1994;26(5):786-793.

Abstract PDF: The present randomized, prospective study was designed to assess whether alternating etoposide, cisplatin (EP) and cyclophosphamide, adriamycin, vincristine (CAV) is better than etoposide, cisplatin (EP) chemotherapy in improving response, survival and remission duration in 62 evaluable patients having extensive-stage small-cell lung cancer.(SCLC) There were no significant differences in treatment outcome for EP alone, EP/CAV in terms of response rate (65/ versus 75%), complete response rate (9% versus 7%), remission duration (5 months versus 5 months) or median survival (10 months versus 1 l months). Severe myelosuppressian was more common in EPiCAV alternating treatment. The EP/CAV alternating regimen and EP alone regimen can be considered equivalently effective induction therapies in extensive SCLC and these two regimens are, to some degree, cross resistant. Alternating therapy provides no therapeutic advantage with more myelosuppression compared to the EP alone chemotherapy and should not be considered as standard treatment in this clinical setting.

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Expression of p53 in the Benign and Malignant Tumor of Prostate: Ki Kwon Kim; J Korean Cancer Assoc. 1994;26(5):793-801.

Abstract PDF: Immunohistochemical expression of the p53 was studied in 20 csses of benign proststic hypertrophy(BPH) and 56 prostatic adenocarcinomas using a monoclonal p53-specific DO7 anti- body (Novocastra, U.K.) on formaline-fixed paraffin-embedded tissue sections. Proliferative activity was determined by immunahistochemical detectian of proliferative cell nuclear antigen (PCNA) using a monoclonal PCIO antibody (Novocastra, U.K.). Eleven of 56 prostatic carcinomas(19.6%) showed strong immunostaining for p53 in more than 20% of tumor cells and 15 (28.6%) had focal(<=20%) immunoreactivity. The glandular epithelium adjacent to carcinomas showed features of prostatic intraepithelial neoplasia which was stained positively for p53 in 25%,but all cases of BPH showed no staining. High grade carcinomas(Gleasons combined score >=7) were associated with more intense and extensive p53 staining. High PCNA staining(higher than 50%)showed more p53 immunoreactivity(81.8%) than those cases with lower PCNA staining(40%). These findings indicste that altered expression of p53 protein occurs in a prostate cancer and is associated with increased proliferative activity and appears to play a role in the develpment of highly malignant prostatic carcinomas.

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Determination of Lymphadenectomy in Primary Penile Carcinoma According to the Corpus Cavernosum Invasion: Tack Lee, Sung Joon Hong; J Korean Cancer Assoc. 1994;26(5):801-806.

Abstract PDF: A total of 31 patients with penile carcinoma were retrosrectively analysed. Patients were treated either by partial or total penectomy. Twenty one patients had corpus cavernosum inva- sion and other 7 patients exhibited no such invasion. Tumor grades were well differentiated (GI) in 7, moderately differentiated(GII) in 12 and poorly differentiated(GIII) in 10 respectively. Twenty patients underwent inguinal node dissectian. Metastatic nodes could be correlated with cavernosal invasion but not with tumor grade. When tumor grade and stage were analyzed simultaneously, none of Tl GI-III patients(0/4) developed nodal metastasis, but 75% of patients(12/16) with T., GI-III develaped metastasis. Thereby justifying 'wait and see' approach in patients without cavernosal invasion, but early or praphylactic lymphadenectomy should be performed in patients with cavernosal invaaion.

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COP - BLAM Combination Chemotherapy for the Treatment of Intermediate and High Grade Non - Hodgkin's Lymphoma: Jae Seong Lee, Jang Su Suh, Myung Soo Hyun; J Korean Cancer Assoc. 1994;26(5):806-815.

Abstract PDF: Between March 1987 and December 1993, 45 patients with intermediate and high grade non- Hodgkin's lymphoma were treated with a COP-BLAM(cyclophosphamide, oncovin, prednisone, procarbazine, bleomycin, adriamycin) combination chemotherapy. The median age was 49 years(range 16-76). 29 patiets were male and 16 patients were female. The common histologic types were diffuse large cell type(68.9%), diffuse small cleaved cell type(13.3%), and diffuse mixed small and large cell type(11.1%). The proportion of patients with 'B symptom, bulky mass, and LDH>550 IU/L at diagnosis was 42.4%, 6.7%, 33.3%, respectively. The rate of complete remission was 71.1%, and overall response rate was 93.3%. 2 year survi- val rate was 76.8/, but the median survival time was not reached right now(the median follow up time: l7 months). Age, serum LDH level at diagnosis, lower performance scale, stage, and cell type were significantly associated with CR rate. Stage, serum LDH level at diagnosis, and bulky mass were significantly associated with 2 year survival rate. Overall toxicity was acceptible without any treatment related deaths.

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The Comparison of Blood TNF - α Level between Normal Person and Cancer Patients , and the Change of Blood TNF - α Level in Cancer Patients Receivint the Ablation Chemotherapy Regimens: Yong Koo Lee, Kyoung Nyeon Kim; J Korean Cancer Assoc. 1994;26(5):815-822.

Abstract PDF: Tumor Necrosis Factor(TNF) is a polypeptide hormone produced in vivo by activated macrophages and lymphocytes, and they called TNF-a and TNF4 respectively. TNF has diverse biological effects which may provide either benefical or detrimental to the host depending on the amount of TNF produced. Blood concentration of tumor necrosis factor- a(TNF-a)were measured by enzyme-linked immunosorbent assay(ELISA) methods in 28 patients receiving the ablative chemotherapy regimens. And serum TNF-a level of patients with solid tumors were examined(esophegeal 10, gastric 10, and lung 8)along with 27 healthy controis. The most striking finding was spontaneous production of TNF-a in a significant proportion of cancer patients(28.72+-23.74 pg/ml: p<0.005) against control person. We also found that chemotherapy increased TNF-a production with 48.4+-23.69 pg/mL This increase was significant(p<0.005) compared to the prechemotherapy. Activated macrophage have been shown to exhibit selective cytotoxicity for neoplastic cells and are thought to play a significant role in tumor regression. There is experimental evidence for its interaction with other biological agents and cytotoxic drugs. Several chemotherapy agents might increase macrophage-generated TNF-a through some mechanisms. For TNF-a the biological agents and importance is certain and methods designed to antagonize the release or effects of TNF may have clinical application.

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Expression and Distribution of Acid Stable Trypsin Inhibitor in Primary Carcinomas: Hwang Hee Lee, Won Hee Jang, Chang Jin Kim, Seon Yang Park, Hyung Bae Moon, Ook Joon Yoo; J Korean Cancer Assoc. 1994;26(5):822-828.

Abstract PDF: The distribution and localization of acid stable trypsin inhibitor(ASTI) in malignant human tissues from six different organs were examined using immunohistochemica1 techniques. ASTI immunoreactivity was detected in most of the malignant tissues examined. It was found that ASTI existed not only in the extracellular space but also in the cytoplasm of the malignant cells. Results of immunohistochemical studies suggest that the malignant cells themselves could produce ASTL

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A Case of Dermatomyositis Accompanying Breast Cancer: Young Cheol Kwon, Geu Seung Whang, Moo Youp Choo, Whan Gon Yoon, Kyung Tae Kim, Jae Min Jeon, Bae Young Kim, Seong Kuen Choi, Hee Kwon Ahn, Ju Taek Lee; J Korean Cancer Assoc. 1994;26(5):828-833.

Abstract PDF: Dermatomyositis is a disease of unknown etiology characterized by proximal muscle weak- ness and specific cutaneous findings. This disorder is closely related to polymyositis, which has al1 the muscular features of dermatomyositis without the presence of skin disease. Dermatomyositis seems to be characterized by an increased frequency of internal malignancy. We wish to report herein a case of dermatomyositis associated with breast cancer in 43- year-old woman, and reviewed the literature on the relationship of dermatomyositis and malignancy.

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Occult Breast Cancer Presenting as an Axillary Lymph Node: Sung Yong Kim, Min Hyuk Lee, Kyung Bal Hur, So Yeung Jin; J Korean Cancer Assoc. 1994;26(5):833-841.

Abstract PDF: Cancer of many organs may first manifest itself by regional lymph node metastasis. Examples include cervical nodes from the upper respiratory tract, supraclavicular nodes from the gastrointestinal tract and axillary nodes from the breast. Occult breast cancer presenting as an axillary lymph node is rare disease. Recently, authors experienced two cases of occult breast cancer presenting an an axillary lymph node. One patient was 40 year old female, and treated with left axillary lymph node dissection, radiation therapy to left breast and combination chemotherapy. She had 27 positive out of 31 axillary lymph node and was free of disease for 35 months. The other patient was 44 year old female, undertaken same management of right axilla and breast as the above patient. She had all 12 positive axillary lymph node, but developed breast cancer in the ipsilateral breast 6 months later and died from metastatic breast cancer 16 months after surgery. We reported two cases of occult breast cancer.presenting as an axillary lymph node with review of literature.

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Serious Toxicities Induced by Vinblastine Overdose in a Patient with Relapsed Hodgkin's Disease: Sang Kook Han, Yong Joo Kim, Ji Youn Han, Jin Hyoung Kang, Han Lim Moon, Young Seon Hong, Hoon Kyo Kim, Kyung Shik Lee, Dong Jip Kim; J Korean Cancer Assoc. 1994;26(5):841-847.

Abstract PDF: Vinblastine, referred to as a vinka alkaloid, has been used as a component of the various chemotherapeutic regimens in the treatment of nonseminomatous testicular carcinoma, chorioearcinoma, non-small cell lung carcinoma, bladder cancer, head and neck cancer and cervical cancer. Vinblastine has been used as a main component of ABVD combination therapy for the patients with advanced Hodgkins disease who relapsed after therapy with the MOPP regimen. The major adverse effects of usual dosage of vinblatine are myelosuppression, nausea, vomiting, local effects(phlebitis, necrosis when extravasated), and peripheral and autonomic neuropathies. We experienced the life threatening toxicities including bone marrow suppression, oral mucositis, peripheral neuropathies and paralytic ileus in a 41-year-old male patient with re- lapsed Hodgkins disease who was errorneously treated with 50 mg of vinblastine. The patient was recovered completely with intensive supportive treatment.

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A Case of Multiple Myeloma with Non - Hodgkin's Lymphoma: Heung Moon Chang, Won Seok Kim, In Shon, Chul Woo Kim, Dae Seog Heo, Yung Jue Bang, Seon Yang Park, Byoung Kook Kim, Noe Kyeong Kim; J Korean Cancer Assoc. 1994;26(5):847-853.

Abstract PDF: Concurrent appearance of multiple myeloma with non-Hodgkins lymphoma was rare. We report a case of multiple myeloma with non-Hodgkin's lymphoma in a 75-year-old male. Multiple myeloma was diagnosed previously and then treated with combination chemotherapy. No evidence of the disease was seen after total 32 cycles of combination chemotherapy. Five years later, non-Hodgkins lymphama was developed in his left tonsil without recurrence of multiple myeloma. Whether both tumors derived from the same clone or not was unknown.

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