Because "the standard" chemotherapy for advanced gastric adenocarcinoma, the FAM combination of 5-fluorouracil, adriamycin, and mitomycin, is only minimally effective, there is a clear need for other choices. Therefore, the Southwest Oncology Group tested the new adriamycin analog, bisantrene, hoping that it might be more effective than the "parent drug." Twenty-six patients with gastric adenocarcinoma were treated on a program of every-3-week 2-hour bisantrene infusions. The starting dose was 260 mg/m2 (208 if poor risk), with subsequent doses based on prior toxicity. The regimen caused sufficient toxicity (especially local phlebitis with pain and swelling) to assure an adequate test. One person (3.8% of eligible patients) experienced a clinically useful 3-month response. He had previously had progressive disease on FAM. Nevertheless, we conclude that bisantrene is not an addition to the small list of drugs useful in the management of gastric adenocarcinoma.

Tests for leukoagglutinins and lymphocytotoxic antibodies were performed on sera from 34 recipients of 78 transfusions of leukocytes obtained from donors with chronic myelogenous leukemia. The presence of preformed leukocyte alloantibodies directed against donor cells predisposed to transfusion reactions of variable severity and failure of the transfused cells to survive and circulate in their new host. Studies in vitro demonstrated that these antibodies could inhibit granulocyte phagocytosis and bactericidal capacity. Pretransfusion compatibility testing for transfusion of leukocytes is recommended. Leukocytes should not be given if they are agglutinated by the recipient's serum or if the lymphocytes show damage in lymphocytotoxicity tests.