Ten children with recurrent metastatic (stage IV) neuroblastoma received local radiation therapy, supralethal chemotherapy, and total-body irradiation. Rescue with infusions of either allogeneic (four patients) or autologous (six patients) bone marrow followed. The drugs given to the first two patients were individualized combinations based on previous tumor responses. Both patients died with recurrent tumor three and nine months posttransplant. The eight remaining patients were treated more uniformly with local irradiation, VM-26, doxorubicin, melphalan (L-phenylalanine mustard), and 1,000-rad total-body irradiation in three fractions. Two of these patients had cardiac dysfunction and received no doxorubicin. Three children died in the immediate posttransplant period with disseminated fungal infections. A fourth relapsed and died nine months posttransplant. As of December 1, 1983, two children who received allogeneic marrow grafts have survived in complete remission for 54 and 36 months, and two children who received autologous marrow grafts have survived in complete remission for 35 and 22 months. These results suggest that relapsed metastatic neuroblastoma can be controlled by supralethal combinations of chemotherapy and irradiation coupled with bone-marrow rescue.
Cancer 39:2508-2512, 1977.
EUROELASTOMAS, A MALIGNANT TUMOR OFN the sympathetic nervous tissue, usually occurs in children. I n the majority of patients the disease is disseminated at the time of diagnosis, most commonly to bone, bone marrow, lymph node or liver. The disease is presumed to spread via the lymphatic or hematogenous routes. I n one reported case circulating neuroblasts were observed in a peripheral blood smear, suggesting that hematogenous dissemination of neuroblastoma may be possible. T h e following report provides direct evidence that neuroblastoma cells do circulate. A neuroblastoma cell line (CHP-126BL) has been established from a heparinized peripheral blood specimen obtained from a patient with disseminated neuroblastoma. The morphology, neural enzyme content, and karyotype of this cell were compared to data obtained from a cell line CHP-126 established from the patient's primary tumor.
CASE REPORTJ.R., a 19-month-old female was diagnosed as having Stage 111 neuroblastoma by the staging criteria of Evans et aLs Surgical exploration with a partial resection of the tumor was performed and histologic studies confirmed the diagnosis of neuroblastoma. The cell line CHP-126 was isolated from the tumor specimen as reported by Schlesinger et al. ' Postoperative radiation therapy was given to the retroperitoneal primary tumor to a total dose of 1600 rads in eight treatments over 11 days. Subsequently cyclophosphamide was given 10/mg kg/d for 7 to 10 days every 28 days.Two months from diagnosis disseminated disease was apparent and she was treated with Adriamycin, DTIC (dimethyl-triazeno imidazol carboxamide) and additional palliative radiotherapy. During the last admission, four months after diagnosis, a sterile heparinized peripheral blood specimen was obtained to establish a permanent lymphoblastoid cell line. The patient died one month later.
MATERIALS AND METHODS
Tissue CultureHeparinized peripheral blood was allowed to settle at room temperature, the leukocyte rich plasma was then removed and washed twice with Hanks balanced salt solution (HBSS). T h e leukocyte yield was 5 X 106viable cells/l.O cc of whole blood. In a n attempt to establish an EBVtransformed lymphocyte cell line in vztro the cells were infected with the cell free supernatant fluid from the B95-8 lymphocyte cell line.6 T h e mixture was incubated at 37OC-5% Coz in medium RPMI-1640 with 20% inactivated fetal calf se-
The lipid composition of both intracellular and extracellular forms of' the ERA strain of rabies virus grown in BHK/21 cells was determined. The lipids from purified preparations of both intracellular and extracellular virus yielded 57 and 58% neutral lipid, respectively. The phospholipids of the intracellular and extracellular virus constituted 43 and 42%, respectively. Triglyceride and cholesterol appear to be the major neutral lipids, whereas sphingomyelin, phosphatidylethanolamine, and phosphatidylcholine comprise the major bulk of phospholipid in both virus types. The molar ratio of cholesterol to phospholipid was 0.87 (intracellular) and 0.92 (extracellular). On the basis of the data presented, it is reasonable to assume that the lipids of both intracellular and extracellular rabies virus are similar.
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