Daniel E. Lehane

because they seemed to recover in two or three days, had their symptoms attributed by parents to some dietary indiscretion. The fact that so many children in this home fell ill in so short a time, immediately suggested that this outbreak was of an infectious nature. During a period of 16 days 19 cases occurred, 13 of them in the space of six days, but an accurate incubation period cannot be deduced from these figures. So far as the children were concerned, the numbers were too small to detect whether age or sex was associated with susceptibility to the virus.

In a previous report (Finn et al., 1961) we gave reasons for thinking that the rapid removal of Rh-positive foetal erythrocytes from the circulation of a mother who was Rh-negative would prevent her from becoming immunized and producing Rh antibodies. We have now investigated the matter further, and the present paper describes the completed results of the earlier work (Experiment I) and then gives details of some subsequent observations (Experiments II and III). The reasoning involved and the scope of the investigations are first discussed.

Chemotherapy (doxorubicin, cyclophosphamide, and vincristine) was given in a sequential fashion with radiation of the primary tumor and brain to 358 patients with small-cell lung carcinoma (extensive disease in 250, limited in 108). Complete regression of tumor was obtained in 14% of patients with extensive disease and 41% of patients with limited disease, and complete or partial response in 57% and 75%, respectively. Median survival was 26 weeks for patients with extensive disease and 52 weeks for those with limited disease. Response duration was longer for patients in complete remission; one third had disease-free survival greater than 1 year. Toxicity from the combined treatment modalities was no greater than expected from the components given separately: fatal in 3.9%, and life-threatening but reversible in 8.4% of patients. Whole-brain radiation was effective in preventing isolated relapse at that site. This therapy appears both feasible and effective, with acceptable risks and some benefit to most patients.

PROTEIN A, a constituent of the cell wall of Staphylococcus aureus Cowans 1 (SpA), reacts with the Fc region of immunoglobulins from many mammalian species and combines with immune complexes in serum.1 2 3 4 Previously, tumoricidal effects were observed in a patient with cancer of the colon after administration of autologous plasma that had been circulated over immobilized SpA.5 This approach was extended to dogs with spontaneous breast adenocarcinoma, and rapid and extensive tumor necrolytic reactions were noted after plasma perfusion over SpA but not over protein A-deficient staphylococcus.6 , 7 These findings were confirmed in an independent study.8 Similar tumor necrolytic responses were . . .

In a randomized and stratified study, 294 patients with advanced gastrointestinal cancer were treated either with 5-fluorouracil (5-FU) 400 mg/m2 weekly intravenously (i.v.) or 5-FU 400 mg/m2 i.v. weekly plus methyl-CCNU 175 mg/m2 orally (p.o.) every 6 weeks. The response rate in colorectal cancer with 5-FU was 9.5% while the two-drug treatment produced a response of 31.8% (p=.009). The response in all gastrointestinal cancers to 5-FU was 10.6% as compared with29.3% for the combination (p=.012). All responses were partial. The two-drug regimen is more effective and more toxic than weekly 5-FU therapy.