1. Walls of Staphylococcus lactis 2102 contain about 40% of a phosphorylated polysaccharide, which was isolated by extraction with cold trichloroacetic acid, with dilute NaOH, and also by digestion with a Flavobacterium peptidase. 2. The purified polymer contained equimolar proportions of N-acetylglucosamine and phosphate as its sole constituents and was readily hydrolysed under gentle acidic conditions to N-acetylglucosamine 6-phosphate. 3. Studies on the intact polymer showed that it is linear and that adjacent acetamido sugar units are joined by phosphodiester bonds between their 1- and 6-positions, the glycosidic linkages having the alpha-configuration. This polymer is thus the simplest of the known microbial wall polymers possessing sugar 1-phosphate linkages. 4. Alkali degradation of the extracted polymer proceeds predominantly in a stepwise manner from the reducing end, but evidence was obtained for the direct hydrolysis of some of the inter-unit phosphodiester groups.
Ten percent to 20% of patients with Hodgkin Lymphoma (HL) are refractory to first-line therapy or relapse. Existing salvage regimens have response rates of 60-85%, considerable toxicity and frequent treatment delay or dose reduction. We report a gemcitabine, cisplatin, and dexamethasone regimen (GemCis) with intensive growth factor and platelet support and no treatment delay. Seventeen patients with relapsed or refractory biopsy proven HL were treated. Toxicity, transfusion requirement, stem cell harvesting and engraftment data were collected. Response assessment was by computed tomography and positron emission tomography. Overall and complete response rates were high (94% and 65%, respectively). There were no episodes of febrile neutropenia, treatment delays or hospital admissions. All 15 patients intended for autograft were successfully harvested. All engrafted successfully with a median time for the entire group to neutrophil engraftment of 14 days. With a median followup of 22 months, the median survival has not yet been reached, and the estimated 2-year survival is 88%. GemCis is a well-tolerated outpatient regimen for relapsed/ refractory Hodgkin lymphoma which does not inhibit stem cell mobilisation, gives excellent response rates and compares favourably with previously published salvage regimens using these or other chemotherapy agents.
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