RESUMO
Adaptor chimeric antigen receptor (CAR) T-cell therapy offers solutions for improved safety and antigen escape, which represent main obstacles for the clinical translation of CAR T-cell therapy in myeloid malignancies. The adaptor CAR T-cell platform 'UniCAR' is currently under early clinical investigation. Recently, the first proof of concept of a well-tolerated, rapidly switchable, CD123-directed UniCAR T-cell product treating patients with acute myeloid leukaemia (AML) was reported. Relapsed and refractory AML is prone to high plasticity under therapy pressure targeting one single tumour antigen. Thus, targeting of multiple tumour antigens seems to be required to achieve durable anti-tumour responses, underlining the need to further design alternative AML-specific target modules (TM) for the UniCAR platform. We here present the preclinical development of a novel FMS-like tyrosine kinase 3 (FLT3)-directed UniCAR T-cell therapy, which is highly effective for in vitro killing of both AML cell lines and primary AML samples. Furthermore, we show in vivo functionality in a murine xenograft model. PET analyses further demonstrate a short serum half-life of FLT3 TMs, which will enable a rapid on/off switch of UniCAR T cells. Overall, the presented preclinical data encourage the further development and clinical translation of FLT3-specific UniCAR T cells for the therapy of AML.
Assuntos
Leucemia Mieloide Aguda , Tirosina Quinase 3 Semelhante a fms , Humanos , Animais , Camundongos , Tirosina Quinase 3 Semelhante a fms/genética , Tirosina Quinase 3 Semelhante a fms/metabolismo , Imunoterapia Adotiva , Linfócitos T , Antígenos de Neoplasias , Leucemia Mieloide Aguda/tratamento farmacológicoRESUMO
Surgical interventions close to vulnerable structures, such as nerves, require precise handling of surgical instruments and tools. These tools not only pose the risk of mechanical damage to soft tissues, but they also generate heat, which can lead to thermal necrosis of bone or soft tissues. Researchers and engineers are trying to improve those tools through experimentation and simulations. To simulate temperature distributions in anatomical structures, reliable material constants are needed. Therefore, this study aimed at investigating the thermal conductivity of cortical and cancellous bone. Accordingly, a custom-made steady-state experimental setup was designed and validated. 6 bovine and 3 human cortical bone samples, as well as 32 bovine cancellous bone samples, with variable bone volume fraction were tested. The cancellous bone samples were scanned by micro-computed tomography (µCT) and micro-finite element (µFE) voxel models were created to calculate iteratively the thermal conductivity of the bone marrow. The experimental results provided 0.64 ± 0.04 W/mK for bovine cortical bone and 0.68 ± 0.01 W/mK for human cortical bone. A linear dependency of thermal conductivity on bone volume fraction was found for cancellous bone [R-square (R2) = 0.8096, standard error of the estimates (SEE) = 0.0355 W/mK]. The thermal conductivity of the bone marrow was estimated to be 0.42 ± 0.05 W/mK. These results will help to improve thermal finite element simulations of the human skeleton and aid the development of new surgical tools or procedures.
Assuntos
Osso Esponjoso/fisiologia , Osso Cortical/fisiologia , Condutividade Térmica , Idoso de 80 Anos ou mais , Animais , Medula Óssea/anatomia & histologia , Bovinos , Feminino , Temperatura Alta , Humanos , Análise de Regressão , Microtomografia por Raio-XRESUMO
OBJECTIVE: Tooth color matching is challenging, and digital photocolorimetry using eLABor_aid (eLAB) provides objective evaluation through polarized photographs. However, its comparability with spectrophotometry remains unclear. METHODS AND MATERIALS: Bovine incisor root canals (n=30) were prepared to simulate an incomplete root apex. The teeth were randomly assigned to three groups based on intracanal medication: control (without medication); calcium hydroxide/propylene glycol; and triple-antibiotic paste (n=10 each). Tooth color was assessed using both eLAB and spectrophotometry. Measurements were taken at the crown medio-cervical region on five-time intervals (baseline, 1, 3, 7, and 14 days). Statistical analysis included two-way repeated-measures ANOVA, Sidak post hoc and Pearson's correlation test (α=0.05). RESULTS: No significant differences were observed between the two methods for either medication or follow-ups (p>0.05). Triple-antibiotic paste exhibited higher color variation (p<0.05). After 7 days, all groups presented significant color changes (p<0.05). Moderate to high correlations (R2 from 0.51 to 0.84, p<0.0001) were found between both methods for all groups at all intervals. CONCLUSION: The eLAB is a reliable method for detecting tooth color changes, and its results are comparable to spectrophotometry analysis.
Assuntos
Colorimetria , Espectrofotometria , Bovinos , Animais , Espectrofotometria/métodos , Colorimetria/métodos , Antibacterianos , Cor , Técnicas In Vitro , Hidróxido de Cálcio , Incisivo/anatomia & histologia , Propilenoglicol , Descoloração de Dente , Irrigantes do Canal Radicular/uso terapêutico , Metronidazol/uso terapêutico , Ciprofloxacina/uso terapêutico , Cavidade Pulpar/anatomia & histologiaRESUMO
BACKGROUND: Theory of Mind (ToM) is an ability to understand and interpret another person's beliefs, emotions, and intentions. ToM requires both cognitive and emotional perspective taking and is deficient in several neuropsychiatric disorders all connected with impaired social functioning. Cognitive and mood dysfunctions have been recognized as common symptoms in multiple sclerosis (MS). METHODS: We investigated social cognition in 40 ambulatory patients with MS compared to 35 healthy controls by using verbal and non-verbal ToM tests (Faux Pas, Baron-Cohen's Adult Eyes and Faces test) and Baron-Cohen's Empathy questionnaire. The effect of disability and disease duration on social cognition was also analyzed by multiple logistic regression analysis after adjusting for confounding factors of age, gender, intelligence, depression, and anxiety. RESULTS: Even when adjusted, patients with MS made significantly more mistakes in non-verbal test (adult Eyes Test), and more disabled patients performed worse in both verbal and non-verbal ToM tests (Eyes Test and Faux Pas) compared to controls. Patients with a shorter disease course described themselves as more empathetic. DISCUSSION: In the absence of marked cognitive decline and disability, patients with ambulatory MS had a deficit interpreting social situations and performing in interpersonal contexts.
Assuntos
Cognição , Esclerose Múltipla Recidivante-Remitente/psicologia , Percepção Social , Teoria da Mente , Adulto , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Estudos de Coortes , Avaliação da Deficiência , Progressão da Doença , Inteligência Emocional , Feminino , Humanos , Modelos Logísticos , Masculino , Esclerose Múltipla Recidivante-Remitente/complicações , Testes Psicológicos , Índice de Gravidade de Doença , Inquéritos e Questionários , Fatores de TempoRESUMO
OBJECTIVE: We tested the association between theory of mind (ToM) performance and structural changes in the brains of patients in the early course of schizophrenia. METHOD: Voxel-based morphometry (VBM) data of 18 patients with schizophrenia were compared with those of 21 controls. ToM skills were assessed by computerized faux pas (FP) tasks. RESULTS: Patients with schizophrenia performed significantly worse in FP tasks than healthy subjects. VBM revealed significantly reduced gray matter density in certain frontal, temporal and subcortical regions in patients with schizophrenia. Poor FP performance of schizophrenics correlated with gray matter reduction in the left orbitofrontal cortex and right temporal pole. CONCLUSION: Our data indicate an association between poor ToM performance and regional gray matter reduction in the left orbitofrontal cortex and right temporal pole shortly after the onset of schizophrenia.
Assuntos
Córtex Cerebral/patologia , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Teoria da Construção Pessoal , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adolescente , Adulto , Cerebelo/patologia , Dominância Cerebral/fisiologia , Feminino , Lobo Frontal/patologia , Hipocampo/patologia , Humanos , Masculino , Testes Neuropsicológicos , Tamanho do Órgão/fisiologia , Escalas de Graduação Psiquiátrica , Valores de Referência , Lobo Temporal/patologia , Adulto JovemRESUMO
PURPOSE: The goal of this study was to compare conventional X-ray defecography and dynamic magnetic resonance (MR) defecography in the diagnosis of pelvic floor prolapse of the posterior compartment. MATERIAL AND METHODS: Fifty women with a mean age of 65.5 years (range: 53-72 years) who underwent X-ray defecography and MR defecography for clinical suspicion of posterior compartment dysfunction, were included in this retrospective study. X-ray defecography and dynamic MR defecography were reviewed separately for the presence of pelvic organ prolapse. The results of the combination of X-ray defecography and MR defecography were used as the standard of reference. Differences in sensitivities between X-ray defecography and MR defecography were compared using the McNemar test. RESULTS: With the gold standard, we evidenced a total of 22 cases of peritoneocele (17 elytroceles, 3 hedroceles and 2 elytroceles+hedroceles), including 15 cases of enterocele, 28 patients with rectocele including 16 that retained contrast, 37 cases of rectal prolapse, and 11 cases of anismus. The sensitivities of X-ray defecography were 90.9% for the diagnosis of peritoneocele, 71.4% for rectocele, 81.1% for rectal prolapse and 63.6% for anismus. The sensitivities of MR defecography for the same diagnoses were 86.4%, 78.6%, 62.2% and 63.6%, respectively. For all these pathologies, no significant differences between X-ray defecography and MR defecography were found. CONCLUSION: Dynamic MR defecography is equivalent to X-ray defecography for the diagnosis of abnormalities of the posterior compartment of the pelvic floor.
Assuntos
Defecografia/métodos , Imageamento por Ressonância Magnética/métodos , Distúrbios do Assoalho Pélvico/diagnóstico por imagem , Prolapso de Órgão Pélvico/diagnóstico por imagem , Retocele/diagnóstico por imagem , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
Surgical robot systems can work beyond the limits of human perception, dexterity and scale making them inherently suitable for use in microsurgical procedures. However, despite extensive research, image-guided robotics applications for microsurgery have seen limited introduction into clinical care to date. Among others, challenges are geometric scale and haptic resolution at which the surgeon cannot sufficiently control a device outside the range of human faculties. Mechanisms are required to ascertain redundant control on process variables that ensure safety of the device, much like instrument-flight in avionics. Cochlear implantation surgery is a microsurgical procedure, in which specific tasks are at sub-millimetric scale and exceed reliable visuo-tactile feedback. Cochlear implantation is subject to intra- and inter-operative variations, leading to potentially inconsistent clinical and audiological outcomes for patients. The concept of robotic cochlear implantation aims to increase consistency of surgical outcomes such as preservation of residual hearing and reduce invasiveness of the procedure. We report successful image-guided, robotic CI in human. The robotic treatment model encompasses: computer-assisted surgery planning, precision stereotactic image-guidance, in-situ assessment of tissue properties and multipolar neuromonitoring (NM), all based on in vitro, in vivo and pilot data. The model is expandable to integrate additional robotic functionalities such as cochlear access and electrode insertion. Our results demonstrate the feasibility and possibilities of using robotic technology for microsurgery on the lateral skull base. It has the potential for benefit in other microsurgical domains for which there is no task-oriented, robotic technology available at present.
RESUMO
The adoptive transfer of CD19-specific chimeric antigen receptor engineered T cells (CAR T cells) resulted in encouraging clinical trials in indolent B-cell malignancies. However, they also show the limitations of this fascinating technology: CAR T cells can lead to even life-threatening off-tumor, on-target side effects if CAR T cells crossreact with healthy tissues. Here, we describe a novel modular universal CAR platform technology termed UniCAR that reduces the risk of on-target side effects by a rapid and reversible control of CAR T-cell reactivity. The UniCAR system consists of two components: (1) a CAR for an inert manipulation of T cells and (2) specific targeting modules (TMs) for redirecting UniCAR T cells in an individualized time- and target-dependent manner. UniCAR T cells can be armed against different tumor targets simply by replacement of the respective TM for (1) targeting more than one antigen simultaneously or subsequently to enhance efficacy and (2) reducing the risk for development of antigen-loss tumor variants under treatment. Here we provide 'proof of concept' for retargeting of UniCAR T cells to CD33- and/or CD123-positive acute myeloid leukemia blasts in vitro and in vivo.
Assuntos
Regulação da Expressão Gênica , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/imunologia , Receptores de Antígenos de Linfócitos T/genética , Linfócitos T/imunologia , Linfócitos T/metabolismo , Animais , Antígenos de Neoplasias/genética , Antígenos de Neoplasias/imunologia , Antígenos de Neoplasias/metabolismo , Citocinas/metabolismo , Citotoxicidade Imunológica , Modelos Animais de Doenças , Vetores Genéticos/genética , Humanos , Imunoterapia Adotiva/métodos , Subunidade alfa de Receptor de Interleucina-3/genética , Subunidade alfa de Receptor de Interleucina-3/imunologia , Subunidade alfa de Receptor de Interleucina-3/metabolismo , Lentivirus/genética , Leucemia Mieloide Aguda/patologia , Leucemia Mieloide Aguda/terapia , Camundongos , Camundongos Knockout , Receptores de Antígenos de Linfócitos T/imunologia , Receptores de Antígenos de Linfócitos T/metabolismo , Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/genética , Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/imunologia , Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/metabolismo , Transdução Genética , Carga TumoralRESUMO
Bispecific antibodies (bsAbs) engaging T cells are emerging as a promising immunotherapeutic tool for the treatment of hematologic malignancies. Because their low molecular mass, bsAbs have short half-lives. To achieve clinical responses, they have to be infused into patients continously, for a long period of time. As a valid alternative we examined the use of mesenchymal stromal cells (MSCs) as autonomous cellular machines for the constant production of a recently described, fully humanized anti-CD33-anti-CD3 bsAb, which is capable of redirecting human T cells against CD33-expressing leukemic cells. The immortalized human MSC line SCP-1 was genetically modified into expressing bsAb at sufficient amounts to redirect T cells efficiently against CD33 presenting target cells, both in vitro and in an immunodeficient mouse model. Moreover, T cells of patients suffering from acute myeloid leukemia (AML) in blast crisis eliminated autologous leukemic cells in the presence of the bsAb secreting MSCs over time. The immune response against AML cells could be enhanced further by providing T cells an additional co-stimulus via the CD137-CD137 ligand axis through CD137L expression on MSCs. This study demonstrates that MSCs have the potential to be used as cellular production machines for bsAb-based tumor immunotherapy in the future.
Assuntos
Anticorpos Biespecíficos/biossíntese , Imunoterapia/métodos , Leucemia Mieloide Aguda/terapia , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/imunologia , Animais , Anticorpos Biespecíficos/uso terapêutico , Complexo CD3/imunologia , Linhagem Celular Tumoral , Citometria de Fluxo , Humanos , Leucemia Mieloide Aguda/imunologia , Ativação Linfocitária/imunologia , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/imunologia , Linfócitos T/imunologia , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
Since it has been hypothesized that atopic dermatitis represents a cellular immune reaction to exogenous aeroallergens, we investigated whether lesional skin contains allergen-specific T-cells and which lymphokines they might secrete. Using phytohaemagglutinin or grass pollen for the cloning procedure, we established a series of T-cell lines from the skin of two patients. When rechallenged with the allergen, three out of 12 dermal lines which had been cloned with the pollen extract and three out of 20 epidermal lines cloned with PHA were found to proliferate specifically. With one exception, allergen-specific lines were CD4+, CD8-, alpha/beta receptor +. The reaction pattern to the single components of the grass allergen extract was assessed with the line UH-D3. Further, the proliferative response to Lolium perennis was inhibited by HLA-DR antibody, indicating its dependence on structures of the MHC class II complex. Only one out of four CD4+ allergen-reactive lines secreted considerable interferon-gamma activity but all secreted interleukin-4. The relative predominance of IL-4 points to a possible role of skin-derived T-cells in the synthesis of IgE. The identification of allergen-specific T-cells in lesional skin of patients with atopic dermatitis is consistent with the hypothesis that their dermatitis represents a T-cell-mediated immune reaction.
Assuntos
Dermatite Atópica/patologia , Pólen/imunologia , Linfócitos T/patologia , Alérgenos/farmacologia , Antígenos de Superfície/imunologia , Antígenos de Superfície/metabolismo , Divisão Celular/efeitos dos fármacos , Linhagem Celular , Dermatite Atópica/imunologia , Dermatite Atópica/metabolismo , Feminino , Humanos , Imunoglobulina E/metabolismo , Imunoglobulina G/metabolismo , Imunoglobulina M/metabolismo , Interferons/metabolismo , Interleucina-4/metabolismo , Linfocinas/metabolismo , Masculino , Pessoa de Meia-Idade , Fito-Hemaglutininas/imunologia , Lectinas de Plantas , Poaceae/imunologia , Pele/imunologia , Linfócitos T/imunologia , Linfócitos T/metabolismoRESUMO
Mature sperm and prophase-1 oocytes of Tetranychus urticae Koch were irradiated with 250-kVp X-rays or 1.5 MeV fast neutrons. The X-ray doses ranged from 0.5 to 24.0 krad, and those of the fast neutrons from 0.1 to 16.0 krad. The genetic endpoint measured was lethality, expressed in the stages from egg to adulthood in the F1 progeny. The frequency of recessive lethals in female germ cells was estimated by comparing survival of fertilized versus unfertilized F1 eggs, after irradiation with the same dosage. X-Rays induce dominant lethals in prophase-1 oocytes by the action of both single hits on single targets and multiple hits on multiple targets. 1.5-MeV neutrons induce these effects predominantly by the action of multiple tracks on multiple targets. Dominant lethals were induced in mature sperm by X-rays and by fast neutrons by the action of both single hits on single targets and multiple hits on multiple targets. Both for prophase-1 oocytes and for mature sperm the low R.B.E. value corresponded with the relatively large multiple-target component of induction of dominant lethals by fast neutrons. The nature of dominant lethality in relation to the kinetochore organization of the chromosome is discussed. A non-linear trend in the dose--effect relationship was observed for both X-rays and fast neutrons for the estimated frequency of recessive lethals induced in prophase-1 oocytes. X-Rays were more effective than neutrons in inducing recessive lethals in prophase-1 oocytes at doses lower than 3 krad.
Assuntos
Frequência do Gene , Genes Dominantes , Genes Letais , Ácaros/genética , Oócitos/efeitos da radiação , Óvulo/efeitos da radiação , Espermatozoides/efeitos da radiação , Animais , Relação Dose-Resposta à Radiação , Feminino , Genes Recessivos , Masculino , Nêutrons , Eficiência Biológica Relativa , Raios XRESUMO
BACKGROUND: Accumulating evidence shows that manipulations of cortical body representation, for example, by simply viewing one's own body, can relieve pain in healthy subjects. Despite the widespread use of the rubber hand illusion (RHI) as an effective experimental tool for the manipulation of bodily awareness, previous studies examining the analgesic effect of the RHI have produced conflicting results. METHOD: We used noxious heat stimuli to induce finger pain in 29 healthy subjects, and we recorded the participants' pain thresholds and subjective pain ratings during the RHI and during the control conditions. Two control conditions were included in our experiment - a standard one with reduced illusion strength (asynchronous stroking control) and an additional one in which the participants viewed their own hand. RESULTS: Raw data showed that both the RHI and the vision of the own hand resulted in slightly higher pain thresholds than the asynchronous stroking control (illusion: 47.79 °C; own-hand: 47.99 °C; asynchronous: 47.52 °C). After logarithmic transformation to achieve normality, paired t-tests revealed that both increases in pain threshold were significant (illusion/asynchronous: p = 0.036; own-hand/asynchronous: p = 0.007). In contrast, there was no significant difference in pain threshold between the illusion and the own-hand conditions (p = 0.656). Pain rating scores were not log-normal, and Wilcoxon singed-rank tests found no significant differences in pain ratings between the study conditions. CONCLUSION: The RHI increases heat pain threshold and the analgesic effect of the RHI is comparable with that of seeing one's own hand. The latter finding may have clinical implications.
Assuntos
Ilusões/fisiologia , Limiar da Dor/fisiologia , Dor/fisiopatologia , Adulto , Imagem Corporal , Feminino , Temperatura Alta , Humanos , Ilusões/psicologia , Masculino , Dor/psicologia , Medição da Dor , Limiar da Dor/psicologia , Adulto JovemRESUMO
Owing to the more recent positive results with the anti-CD33 immunotoxin gemtuzumab ozogamicin, therapy against acute myeloid leukemias (AMLs) targeting CD33 holds many promises. Here, CD33 and CD123 expression on AML blasts was studied by flow cytometry in a cohort of 319 patients with detailed information on French-American-British/World Health Organization (FAB/WHO) classification, cytogenetics and molecular aberrations. AMLs of 87.8% express CD33 and would therefore be targetable with anti-CD33 therapies. Additionally, 9.4% of AMLs express CD123 without concomitant CD33 expression. Thus, nearly all AMLs could be either targeted via CD33 or CD123. Simultaneous presence of both antigens was observed in 69.5% of patients. Most importantly, even AMLs with adverse cytogenetics express CD33 and CD123 levels comparable to those with favorable and intermediate subtypes. Some patient groups with unfavorable alterations, such as FMS-related tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutations, high FLT3-ITD mutant/wild-type ratios and monosomy 5 are even characterized by high expression of CD33 and CD123. In addition, blasts of patients with mutant nucleophosmin (NPM1) revealed significantly higher CD33 and CD123 expression pointing toward the possibility of minimal residual disease-guided interventions in mutated NPM1-positive AMLs. These results stimulate the development of novel concepts to redirect immune effector cells toward CD33- and CD123-expressing blasts using bi-specific antibodies or engineered T cells expressing chimeric antigen receptors.
Assuntos
Subunidade alfa de Receptor de Interleucina-3/biossíntese , Leucemia Mieloide Aguda/imunologia , Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/biossíntese , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Citometria de Fluxo , Humanos , Leucemia Mieloide Aguda/sangue , Leucemia Mieloide Aguda/enzimologia , Leucemia Mieloide Aguda/genética , Masculino , Pessoa de Meia-Idade , Nucleofosmina , Fatores de Risco , Adulto Jovem , Tirosina Quinase 3 Semelhante a fms/sangue , Tirosina Quinase 3 Semelhante a fms/genéticaRESUMO
Owing to their clinical success, there is growing interest in novel bispecific antibodies (bsAbs) for retargeting of T cells to tumor cells including for the treatment of acute myeloid leukemia (AML). One potential target for retargeting of T cells to AML blasts is the surface molecule CD33. Here we describe a novel modular targeting platform that consists of a universal effector module (EM) and individual target modules (TMs). Both modules can form an immune complex via a peptide epitope. The resulting targeting complex can functionally replace a conventional bsAb. By fusion of a costimulatory domain (for example, the extracellular CD137 ligand domain) to the TM, the targeting complex can even provide a costimulatory signal to the redirected T cells at their side of interaction with the tumor cell. Furthermore, we observed that an efficient killing of tumor cells expressing low levels of the tumor target CD33 becomes critical at low effector-to-target cell ratios but can be improved by costimulation via CD137 using our novel targeting system.
Assuntos
Leucemia Mieloide Aguda/imunologia , Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/imunologia , Linfócitos T/imunologia , Animais , Linhagem Celular , Ensaio de Imunoadsorção Enzimática , Humanos , Leucemia Mieloide Aguda/patologia , Ativação Linfocitária , MasculinoRESUMO
UNLABELLED: HISTORY AND PRESENTATION ON ADMISSION: A 70-year-old woman with a history of gastric cancer and palliative chemotherapy was admitted with disturbed consciousness. INVESTIGATIONS: The cranial CT showed a tumor in the left parietocccipital region so that a cerebral metastasis was suspected. However further investigations including cranial MRT, liquor and blood culture collection showed that the immunocompromised patient suffered from a Listeria monocytogenes sepsis with subsequent meningitis and a cerebral abscess. TREATMENT AND COURSE: During an antibiotic treatment with ampicillin and gentamycin a rapid neurological improvement and normalization of the liquor findings was achieved. CONCLUSIONS: Listeria monocytogenes is a rare but relevant cause of systemic inflammations in immunocompromised patients. The differentiation between cerebral abscess and metastasis in cancer patients can be complex but is important concerning differential therapeutic approaches.