Autologous tumor lysate/Bacillus Calmette-Guérin immunotherapy as an adjuvant to conventional breast cancer therapy.

INTRODUCTION: Autologous tumor cell vaccines rely on the concept of preserving an individual's own tumorigenic makeup, expressing its unique set of tumor-associated antigens as well as antigenic elements from the surrounding stroma. These autologous tumor characteristics are usually presented with an immune adjuvant in the hopes of enhancing an immune response. METHODS: The autologous vaccine we used was composed of tumor cells combined with BCG and formalin. Animal safety and toxicity were evaluated using mice tumors for the immunotherapy. A small number of patients with advanced stage breast cancer were recruited for an uncontrolled study, using the vaccine solely or combined with chemotherapy/radiotherapy. RESULTS: The immunotherapy had shown to be safe in mice and humans. Upon a 5-year follow-up, the survival rate was 60 % for the combined treatment. CONCLUSIONS: The data suggest that the combined treatment could be a feasible and safe therapeutic strategy. However, further controlled studies should be conducted.

Natalizumab treatment in multiple sclerosis patients: a multicenter experience in clinical practice in Italy.

We evaluated efficacy of natalizumab in relapsing-remitting multiple sclerosis patients in a clinical practice setting. We report data on the first consecutive 343 patients receiving natalizumab in 12 multiple sclerosis (MS) Italian centers enrolled between April 2007 and November 2010. The main efficacy endpoints were the proportion of patients free from relapses, disease progression, combined clinical activity, defined as presence of relapse or disease progression, from MRI activity, and from any disease activity defined as the absence of any single or combined activity. At the end of follow-up, the cumulative proportion of patients free from relapses was 68%; the proportion of patients free from Expanded Disability Status Scale (EDSS) progression was 93%; the proportion of patients free from combined clinical activity was 65%; the proportion of patients free from MRI activity was 77%; and the proportion of patients free from any disease activity was 53%. Natalizumab was effective in reducing clinical and neuroradiological disease activity. Its effectiveness in clinical practice is higher than that reported in pivotal trials and was maintained over time.

CD4 mononuclear cell infiltrates and Fas/Fas ligand positive mammary gland cells in breast tissue from a patient with Sjögren's syndrome.

We describe a 49-year-old patient with lip biopsy proven Sjögren's syndrome (SS) and keratoconjunctivitis sicca, who had dental caries, xerostomia, recurrent upper respiratory tract infections, arthritis in her hands, elbows and knees, and recurrent parotid inflammation. She developed bilateral breast nodules in 1988. Right breast nodules were excised in 1993 and 1995, but reappeared in 1996, requiring 2 more excisions. Breast tissue samples showed remarkable intralobular and perilobular mononuclear cell infiltrates that were predominantly CD4+ T cells and expressed bcl-2. A few cells stained CD20+ and CD8+. SS breast glandular epithelial cells stained more intensely for Fas compared to normal cells. CD4+ T cells and Fas mediated cell death may be involved in the mammary gland lesions in SS.

[Puncture-aspiration biopsy with fine needle]. / Biopsia por punción-aspiración con aguja fina.

The results of one hundred and sixty nine fine needle aspiration biopsy procedures with complete follow-up are evaluated. The biopsies were performed with a 21G needle with a slight modification at the distal end. For breast, a 21G 1-1/2'' hypodermic needle was used. Samples were taken mostly from breast (34.3%), lung/mediastinum (32.5%) and liver (18.3%). Guide method was determined by the location of the lesion. Palpation was preferred for breast and superficial tumors, fluoroscopy for lung and bone and ultrasound for any other. Malignancy was diagnosed in 98 (57.99%), non-malignancy in 61 (36.09%) and 10 (5.92%) were suspicious for malignancy. All malignant cases correlated with final diagnosis. Out of 10 suspicious cases, 8 proved to be malignant and the two others were benign, they were considered as false positive. Of the 61 cases diagnosed as benign, 50 were confirmed and in 11 the diagnosis of malignancy was established representing the false negative. Correlation rate was estimated in 92.31%; sensibility in 90.6% and specificity in 96.15%. The malignant predictive value was 99% and benign predictive value 79%. The management of fine needle biopsy specimen with appropriate histotechnics procedures, can produce a very rich preparation that can give us a detailed histological diagnosis that correlates exactly in 75% of the cases. The method was especially helpful as the first approach in patients with metastases of unknown primary. Complications occurred only in thoracic punctures where they reach 20.88% of the thorax cases. No fatalities were registered.