Intracavitary bacillus calmette-guerin in the treatment of superficial bladder tumors

Morales, Álvaro; Eidinger, D.; Bruce, Andrew W.

doi:10.1016/s0022-5347(02)80294-4

Cited by 131 publications

(105 citation statements)

References 15 publications

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“…Around that time, it was already observed that mycobacterial infection might have a mitigating effect on malignant disease (2). Since the 1960s, BCG has been used as an immunotherapeutic agent in acute lymphoblastic leukemia, in malignant melanoma and particularly in TCC of the bladder (1,4,5). Today, local BCG immunotherapy for early stages of TCC is a well established treatment option, with success rates ranging from 64% to 94% -higher than for any chemotherapeutic agent (2).…”

Section: Discussionmentioning

confidence: 99%

Hepatitis in Disseminated Bacillus Calmette-Guérin Infection

Göttke

Wong²,

Muhn³

et al. 2000

Canadian Journal of Gastroenterology

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Local immunotherapy with an attenuated live strain of Mycobacterium bovis, bacillus Calmette-Guérin (BCG), is an effective and frequently used treatment for in situ transitional cell carcinoma (TCC) of the bladder. Success rates are high, and serious side effects are infrequent but can affect every organ system. A 79-year-old patient with recently diagnosed TCC who was treated with intravesical BCG for a recurrence after initial surgical treatment is reported. After unsuccessful attempts at bladder catheterization with the creation of a false passage for his third treatment, BCG was instilled via a suprapubic catheter the same day and again a week later. Two weeks after the third BCG instillation, the patient presented with profound lethargy and weakness to the point of not being able to get up out of a chair. He was febrile, anorexic, icteric and had hepatosplenomegaly. Disseminated BCG infection was suspected on the basis of history, clinical examination and a liver biopsy that showed noncaseating granulomatous hepatitis. Empirical treatment was started with antituberculous combination therapy. A short course of an oral corticosteroid was given. Clinical improvement was marked and sustained so that the patient could be discharged home for the full six-month course of his treatment. Disseminated BCG infection with granulomatous hepatitis can be severe and life-threatening in cases where a large intravascular inoculum of BCG may have been given inadvertently.

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Section: Discussionmentioning

confidence: 99%

Hepatitis in Disseminated Bacillus Calmette-Guérin Infection

Göttke

Wong²,

Muhn³

et al. 2000

Canadian Journal of Gastroenterology

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“…BCG instillations are a cornerstone for superficial bladder carcinoma treatment, and they have changed the prognosis of this disease [4,5]. Septic side effects are rare, between 0.4% and 1/15,000 according to Lamm [5], and the benefit of the treatment remains higher than the risk of such events.…”

Section: Pathogenesis Discussionmentioning

confidence: 99%

“…Bacillus Calmette-Guérin (BCG) is a strain obtained from Mycobacterium bovis, used for vaccination and immunotherapy for bladder cancer since 1976 [4]. Complications of bladder instillations occur in about 5% or less of patients [5], mainly with local urinary adverse effects such as pollakiuria, cystitis or haematuria.…”

Section: Introductionmentioning

confidence: 99%

Back pain following instillations of BCG for superficial bladder cancer is not a reactive complication: review of 30 Mycobacterium bovis BCG vertebral osteomyelitis cases

et al. 2019

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Introduction: Mycobacterium bovis BCG instillations are used in bladder cancer treatment. Adverse effects can occur. Osteoarticular complications are mainly reactive arthritis, but true infections have been described, such as vertebral osteomyelitis. Methods: We made a review of M. bovis BCG vertebral osteomyelitis after instillations for bladder cancer using PubMed search. We added 3 new French cases. Review: Twenty-seven cases of BCG vertebral osteomyelitis had been reported on PubMed. Of the 30 cases, all were male, averaging 73.4 ± 8.7 year-old. Median time between diagnosis and first and last instillation was 22.5 months and 14 months respectively. Half of vertebral osteomyelitis was thoracic, and lumbar in the other half. Sensitivomotor deficit was present at diagnosis in 42% of cases. Other infectious locations were common, mainly infectious abdominal aortic aneurysms (20%). Rifampicin, ethambutol and isoniazid were the usual therapy. Poor outcomes were reported with 50% of one or more spine surgery. Conclusion: M. bovis BCG vertebral osteomyelitis following bladder instillation for bladder cancer is a rare complication. However, the late onset of back pain after instillations differentiates them from reactive arthritis. Concomitant septic location such as infectious abdominal aortic aneurysms must be known.

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“…It is a fact that 54 years later, the first microbial vaccine approved by the US Food and Drug Administration and the European Medicines Agency, for the treatment of cancer was Bacillus Calmette-Guerin (BCG). In 1976, Morales et al [10] were the first to report the use of BCG for treatment of non-muscle invasive superficial bladder tumors. Subsequently, numerous prospective randomized clinical trials demonstrated the efficacy of intravesicle BCG therapy for therapy of Carcinoma-in-situ (CIS) and later for preventing the recurrence with progression, of superficial papillary bladder cancer (Tables 1 and 2).…”

Section: Introductionmentioning

confidence: 99%

Active (Patient Specific) Immunotherapy of Colon Cancer: A Transition from Preclinical Studies to Successful Clinical Trials

Hanna¹

2014

J Clin Cell Immunol

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Intracavitary bacillus calmette-guerin in the treatment of superficial bladder tumors

Cited by 131 publications

References 15 publications

Hepatitis in Disseminated Bacillus Calmette-Guérin Infection

Hepatitis in Disseminated Bacillus Calmette-Guérin Infection

Back pain following instillations of BCG for superficial bladder cancer is not a reactive complication: review of 30 Mycobacterium bovis BCG vertebral osteomyelitis cases

Active (Patient Specific) Immunotherapy of Colon Cancer: A Transition from Preclinical Studies to Successful Clinical Trials

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