Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 1979 Nov;40(5):736–742. doi: 10.1038/bjc.1979.254

Immunotherapy using BCG during remission induction and as the sole form of maintenance in acute myeloid leukaemia.

G P Summerfield, T J Gibbs, A J Bellingham
PMCID: PMC2010104  PMID: 389265

Abstract

Thirty-two adults with acute myeloid leukaemia (AML) were randomized to receive, from the time of diagnosis, either chemotherapy alone (C group) or chemotherapy plus Bacille Calmette-Guérin vaccine (BCG) (C+I group). After remission induction and consolidation, chemotherapy was stopped in both groups but BCG was continued in the C+I group. The overall survival of the C+I group was significantly increased (P less than 0.05). There was no significant increase in the duration of first remission in the C+I group (0.05 less than P less than 0.1) nor in the time from first relapse to death (0.05 less than P less than 0.1). There was no significant difference in the incidence of first or second remissions, and the time taken to enter remission did not differ significantly between the two groups. Comparison with the results of other trials suggests that the use of maintenance chemotherapy in addition to immunotherapy produces longer remissions. Five patients in the C group developed leukaemic central-nervous-system (CSN) involvement, in comparison with none in the C+I group. CNS relapse did not produce a significant decrease in remission length (P greater than 0.1) but reduction in survival after CNS relapse was highly significant (P = 0.001). These results suggest that administration of BCG from an early stage in the treatment of AML may protect the CNS against leukaemic infiltration and therefore serve as a simple, innocuous form of CNS prophylaxis.

Full text

PDF
737

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Crowther D., Powles R. L., Bateman C. J., Beard M. E., Gauci C. L., Wrigley P. F., Malpas J. S., Fairley G. H., Scott R. B. Management of adult acute myelogenous leukaemia. Br Med J. 1973 Jan 20;1(5846):131–137. doi: 10.1136/bmj.1.5846.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Dahl G. V., Simone J. V., Hustu H. O., Mason C. Preventive central nervous system irradiation in children with acute nonlymphocytic leukemia. Cancer. 1978 Nov;42(5):2187–2192. doi: 10.1002/1097-0142(197811)42:5<2187::aid-cncr2820420516>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  3. Drewinko B., Sullivan M. P., Martin T. Use of the cytocentrifuge in the diagnosis of meningeal leukemia. Cancer. 1973 Jun;31(6):1331–1336. doi: 10.1002/1097-0142(197306)31:6<1331::aid-cncr2820310605>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  4. Freeman C. B., Harris R., Geary C. G., Leyland M. J., MaCiver J. E., Delamore I. W. Active immunotherapy used alone for maintenance of patients with acute myeloid leukaemia. Br Med J. 1973 Dec 8;4(5892):571–573. doi: 10.1136/bmj.4.5892.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gutterman J. U., Hersh E. M., Rodriguez V., McCredie K. B., Mavligit G., Reed R., Burgess M. A., Smith T., Gehan E., Bodey G. P., Sr Chemoimmunotherapy of adult acute leukaemia. Prolongation of remission in myeloblastic leukaemia with B.C.G. Lancet. 1974 Dec 14;2(7894):1405–1409. doi: 10.1016/s0140-6736(74)90070-1. [DOI] [PubMed] [Google Scholar]
  6. Mathé G. Approaches to the immunological treatment of cancer in man. Br Med J. 1969 Oct 4;4(5674):7–10. doi: 10.1136/bmj.4.5674.7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Mathé G., Pouillart P., Lapeyraque F. Active immunotherapy of L1210 leukaemia applied after the graft of tumour cells. Br J Cancer. 1969 Dec;23(4):814–824. doi: 10.1038/bjc.1969.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Osborn D. E., Sadler T. E., Castro J. E. Effects of C. parvum on growth and induction of intracerebral tumours in mice. Br J Cancer. 1977 Apr;35(4):420–425. doi: 10.1038/bjc.1977.63. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design. Br J Cancer. 1976 Dec;34(6):585–612. doi: 10.1038/bjc.1976.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Powles R. L., Crowther D., Bateman C. J., Beard M. E., McElwain T. J., Russell J., Lister T. A., Whitehouse J. M., Wrigley P. F., Pike M. Immunotherapy for acute myelogenous leukaemia. Br J Cancer. 1973 Nov;28(5):365–376. doi: 10.1038/bjc.1973.162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Vogler W. R., Chan Y. K. Prolonging remission in myeloblastic leukemia by tice-strain bacillus Calmette-Guérin. Lancet. 1974 Jul 20;2(7873):128–131. doi: 10.1016/s0140-6736(74)91556-6. [DOI] [PubMed] [Google Scholar]
  12. Whittaker J. A., Slater A. J. The immunotherapy of acute myelogenous leukaemia using intravenous BCG. Br J Haematol. 1977 Feb;35(2):263–273. doi: 10.1111/j.1365-2141.1977.tb00583.x. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES