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Lymphocyte activation by recombinant interleukin-2 in ovarian cancer patients
408
SOCIETY
OF GYNECOLOGIC
ONCOLOGISTS-ABSTRACTS
5. Genital Human Papillomcl Virus (HPV) Infections in Male Se.wal Consorts of Women with Cervical Intraepithelial Neoplasia (GIN). H.-B. KREBS AND V. SCHNEIDER. Medical College of Virginia, Richmond, Virginia 23298. The diagnosis and therapy of HPV infections in males is of potential benefit as it will decrease the reservoir of virus from which genital condylomata or squamous neoplasia may arise or recur. To investigate the efficacy of diagnostic methods, the male sexual partners of 127 women with CIN were examined. Eighty-three (65%) mostly asymptomatic men had from I to 40 (median 3) usually small (median 3 mm) HPV-associated lesions including condylomata (80 cases) and penile dysplasia (3 cases). The prepuce was most commonly involved (80%). The colposcope aided in the diagnosis or was necessary for the diagnosis of 59% of the lesions. Routine application of 3 or 5% acetic acid yielded white or grayish changes in 22% of the cases, which would have been missed without this technique. Papular, flat, spiked, and mixed lesions were more common (85%) than papillary changes or classical condylomata (15%). Loop capillaries (“punctation”) were found only in condylomata (23%) and-unlike pigmentation, hyperkeratosis, and acetowhitening-helped to distinguish condylomata from other epithelial changes not associated with HPV infection. Cytologic smears from the external penile surface were unsatisfactory for diagnosis in 96% of the cases irrespective of the sampling site and sampling technique employed. Smears obtained from the male urethra were unsatisfactory in 19% of the cases and yielded positive results in 9 men (7%). It is concluded that condylomata are common in male partners of women with CIN. The lesions are frequently inapparent unless magnification and acetic acid are used. Cytologic smears may aid in the diagnosis of condylomata in the urethra. Biopsy is necessary to distinguish HPV-associated lesions from other abnormalities. 6. Lymphocyte BEREK,
by Recomhincmt Interleukin-2 in Ovarian Cancer Patients. P. BOYER, J. S. Division of Gynecologic Oncology, Department of Obstetrics and and Microbiology and Immunology, UCLA School of Medicine, Los Angeles, California
Activation
AND J. ZIGHELBOIM,
Gynecology, 90024.
A therapeutic trial of intraperitoneal recombinant interleukin-2 (rlL-2) and autologous lymphokineactivated killer (LAK) cells in ovarian cancer is being developed. In order to determine optimal methods of administration, peripheral blood lymphocytes (PBL) and peritoneal cells (PEC) from 42 patients (pts.) with advanced ovarian carcinoma were tested for natural killer (NK) lymphocyte activity and cytotoxicity to several human ovarian carcinoma lines before and after exposure to rIL2 in \,itro for 3-5 days. While 41/42 (98%) pts. demonstrated spontaneous NK cytotoxicity to NKsensitive cell lines, only 4/42 (9.5%) pts. had spontaneous cytotoxicity (>15%) against the ovarian carcinoma lines. After in vitro exposure to rIL-2, 41/42 (98%) pts.’ lymphocytes showed a 2- to 5fold increase in cytotoxicity to NK-sensitive cells, and 40/42 (95%) pts. also demonstrated 15-900/r specific cytotoxicity to the ovarian carcinoma lines. The 2 pts. with the most extensive metastatic disease failed to respond to rIL-2 activation; 4 pts. whose lymphocytes initially failed to respond to rIL-2 while undergoing chemotherapy later became responsive to rIL-2 activation after completion of chemotherapy. All PEC showed less cytotoxicity after rIL-2 exposure than PBL from the same patients. The presence of autologous serum during rIL-2 activation had a suppressive effect on the resulting cytotoxicity in 2/20 pts., an augmentative effect in 4/20 pts., and no effect in l4/20 pts. These data suggest that rIL-2 can effectively augment lymphocyte cytotoxicity toward human ovarian carcinoma, and may therefore be useful in the treatment of the disease. 7. Stented versus Nonstented Trunsverse Colon Conduits. A. M. BEDDOE, J. G. BOYCE, R. G. FRUCHTER,AND J. H. NELSON, JR., State University of New York, Health Science Center, Brooklyn, New York 11203. Postoperative urinary tract complications were evaluated in 75 women who underwent urinary diversion with formation of a transverse colon conduit after radiation for gynecologic cancer. Urinary stents were placed at the ureterocolonic junction in 37 women, while no stents were used in 38 women. Leaks or fistulae developed in 18% of the nonstented group, but in only 3% of the stented group (P < 0.05). Ureteral strictures developed in 18% of the nonstented group, but in only 8% of the stented group. Pyelonephritis developed in 13% of the nonstented and 8% of the stented patients. Overall, urinary tract complications developed in 58% of the nonstented and 16% of the stented patients (P < 0.01). Leaks or strictures developed in 19% of the 75 renal units in the nonstented
SOCIETY
OF GYNECOLOGIC
ONCOLOGISTS-ABSTRACTS
5. Genital Human Papillomcl Virus (HPV) Infections in Male Se.wal Consorts of Women with Cervical Intraepithelial Neoplasia (GIN). H.-B. KREBS AND V. SCHNEIDER. Medical College of Virginia, Richmond, Virginia 23298. The diagnosis and therapy of HPV infections in males is of potential benefit as it will decrease the reservoir of virus from which genital condylomata or squamous neoplasia may arise or recur. To investigate the efficacy of diagnostic methods, the male sexual partners of 127 women with CIN were examined. Eighty-three (65%) mostly asymptomatic men had from I to 40 (median 3) usually small (median 3 mm) HPV-associated lesions including condylomata (80 cases) and penile dysplasia (3 cases). The prepuce was most commonly involved (80%). The colposcope aided in the diagnosis or was necessary for the diagnosis of 59% of the lesions. Routine application of 3 or 5% acetic acid yielded white or grayish changes in 22% of the cases, which would have been missed without this technique. Papular, flat, spiked, and mixed lesions were more common (85%) than papillary changes or classical condylomata (15%). Loop capillaries (“punctation”) were found only in condylomata (23%) and-unlike pigmentation, hyperkeratosis, and acetowhitening-helped to distinguish condylomata from other epithelial changes not associated with HPV infection. Cytologic smears from the external penile surface were unsatisfactory for diagnosis in 96% of the cases irrespective of the sampling site and sampling technique employed. Smears obtained from the male urethra were unsatisfactory in 19% of the cases and yielded positive results in 9 men (7%). It is concluded that condylomata are common in male partners of women with CIN. The lesions are frequently inapparent unless magnification and acetic acid are used. Cytologic smears may aid in the diagnosis of condylomata in the urethra. Biopsy is necessary to distinguish HPV-associated lesions from other abnormalities. 6. Lymphocyte BEREK,
by Recomhincmt Interleukin-2 in Ovarian Cancer Patients. P. BOYER, J. S. Division of Gynecologic Oncology, Department of Obstetrics and and Microbiology and Immunology, UCLA School of Medicine, Los Angeles, California
Activation
AND J. ZIGHELBOIM,
Gynecology, 90024.
A therapeutic trial of intraperitoneal recombinant interleukin-2 (rlL-2) and autologous lymphokineactivated killer (LAK) cells in ovarian cancer is being developed. In order to determine optimal methods of administration, peripheral blood lymphocytes (PBL) and peritoneal cells (PEC) from 42 patients (pts.) with advanced ovarian carcinoma were tested for natural killer (NK) lymphocyte activity and cytotoxicity to several human ovarian carcinoma lines before and after exposure to rIL2 in \,itro for 3-5 days. While 41/42 (98%) pts. demonstrated spontaneous NK cytotoxicity to NKsensitive cell lines, only 4/42 (9.5%) pts. had spontaneous cytotoxicity (>15%) against the ovarian carcinoma lines. After in vitro exposure to rIL-2, 41/42 (98%) pts.’ lymphocytes showed a 2- to 5fold increase in cytotoxicity to NK-sensitive cells, and 40/42 (95%) pts. also demonstrated 15-900/r specific cytotoxicity to the ovarian carcinoma lines. The 2 pts. with the most extensive metastatic disease failed to respond to rIL-2 activation; 4 pts. whose lymphocytes initially failed to respond to rIL-2 while undergoing chemotherapy later became responsive to rIL-2 activation after completion of chemotherapy. All PEC showed less cytotoxicity after rIL-2 exposure than PBL from the same patients. The presence of autologous serum during rIL-2 activation had a suppressive effect on the resulting cytotoxicity in 2/20 pts., an augmentative effect in 4/20 pts., and no effect in l4/20 pts. These data suggest that rIL-2 can effectively augment lymphocyte cytotoxicity toward human ovarian carcinoma, and may therefore be useful in the treatment of the disease. 7. Stented versus Nonstented Trunsverse Colon Conduits. A. M. BEDDOE, J. G. BOYCE, R. G. FRUCHTER,AND J. H. NELSON, JR., State University of New York, Health Science Center, Brooklyn, New York 11203. Postoperative urinary tract complications were evaluated in 75 women who underwent urinary diversion with formation of a transverse colon conduit after radiation for gynecologic cancer. Urinary stents were placed at the ureterocolonic junction in 37 women, while no stents were used in 38 women. Leaks or fistulae developed in 18% of the nonstented group, but in only 3% of the stented group (P < 0.05). Ureteral strictures developed in 18% of the nonstented group, but in only 8% of the stented group. Pyelonephritis developed in 13% of the nonstented and 8% of the stented patients. Overall, urinary tract complications developed in 58% of the nonstented and 16% of the stented patients (P < 0.01). Leaks or strictures developed in 19% of the 75 renal units in the nonstented