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. 1979 Feb;34(1):4–12. doi: 10.1136/thx.34.1.4

Levamisole and surgery in bronchial carcinoma patients: increase in deaths from cardiorespiratory failure.

H M Anthony, A J Mearns, M K Mason, D G Scott, K Moghissi, P B Deverall, Z J Rozycki, D A Watson
PMCID: PMC470998  PMID: 375460

Abstract

Life table analysis of early entry to this randomised blind trial of 318 patients has shown a significantly poorer survival for resected lung cancer patients treated with levamisole for three days before operation and three days a fortnight thereafter than for placebo-treated controls. This excess was largely due to deaths that had been attributed to operation or other causes (non-cancer deaths), most occurring in the six weeks after operation. In the 99 resected patients treated with levamisole there was a 15% excess of deaths in this category, compared with the placebo-treated controls. Extensive analysis excluded maldistribution of patients between the groups as a cause of this difference. Many more died in respiratory distress, mostly without clear cause, in the levamisole group. Antibody (lgG) reacting with myocardial sarcolemma or sarcoplasm was found in the only serum samples available for testing which were drawn from patients during the syndrome. The findings are in keeping with a primary effect on the heart, possibly involving an autoimmune mechanism. The effect has not been noted in other trials.

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Selected References

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

  1. Amery W. K. Double-blind levamisole trial in resectable lung cancer. Ann N Y Acad Sci. 1976;277(00):260–268. doi: 10.1111/j.1749-6632.1976.tb41704.x. [DOI] [PubMed] [Google Scholar]
  2. Amery W. K., Spreafico F., Rojas A. F., Denissen E., Chirigos M. Adjuvant treatment with levamisole in cancer: a review of experimental and clinical data. Cancer Treat Rev. 1977 Sep;4(3):167–194. doi: 10.1016/s0305-7372(77)80023-6. [DOI] [PubMed] [Google Scholar]
  3. Anthony H. M., Templeman G. H., Madsen K. E., Mason M. K. The prognostic significance of DHS skin tests in patients with carcinoma of bronchus. Cancer. 1974 Dec;34(6):1901–1906. doi: 10.1002/1097-0142(197412)34:6<1901::aid-cncr2820340608>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  4. Bernstein A. The postmyocardial infarction syndrome of Dressler. Br J Hosp Med. 1977 Jun;17(6):560–571. [PubMed] [Google Scholar]
  5. Bloth B., Lundman T. Pleuroperimyocarditis caused by immunization with anticatarrh vaccine. A case report. Acta Med Scand. 1977 Jan;201(1-2):137–140. doi: 10.1111/j.0954-6820.1977.tb15669.x. [DOI] [PubMed] [Google Scholar]
  6. Burch G. E. Congestive heart failure is not due to low cardiac output per se. Am Heart J. 1977 Sep;94(3):269–273. doi: 10.1016/s0002-8703(77)80467-5. [DOI] [PubMed] [Google Scholar]
  7. Eilber F. R., Morton D. L. Impaired immunologic reactivity and recurrence following cancer surgery. Cancer. 1970 Feb;25(2):362–367. doi: 10.1002/1097-0142(197002)25:2<362::aid-cncr2820250213>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  8. ICHIKAWA Y. A study of the iso-agglutinin titres in the sera of Australian subjects (white). Jpn J Med Sci Biol. 1959 Apr;12:1–7. doi: 10.7883/yoken1952.12.1. [DOI] [PubMed] [Google Scholar]
  9. Immunopotentiation with levamisole in resectable bronchogenic carcinoma: a double-blind controlled trial; Study Group for Bronchogenic Carcinoma. Br Med J. 1975 Aug 23;3(5981):461–464. doi: 10.1136/bmj.3.5981.461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Israel L. Cell-mediated immunity in lung cancer patients: data, problems, and propositions. Cancer Chemother Rep 3. 1973 Mar;4(2):279–281. [PubMed] [Google Scholar]
  11. Levi G. F., Proto C., Quadri A., Ratti S. Coxsackie virus heart disease and cardiomyopathy. Am Heart J. 1977 Apr;93(4):419–421. doi: 10.1016/s0002-8703(77)80402-x. [DOI] [PubMed] [Google Scholar]
  12. Macfarlane D. G., Bacon P. A. Levamisole-induced vasculitis due to circulating immune complexes. Br Med J. 1978 Feb 18;1(6110):407–408. doi: 10.1136/bmj.1.6110.407. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mourant A. E., Kopeć A. C., Domaniewska-Sobczak K. Blood-groups and blood-clotting. Lancet. 1971 Jan 30;1(7692):223–227. doi: 10.1016/s0140-6736(71)90961-5. [DOI] [PubMed] [Google Scholar]
  14. Parkinson D. R., Cano P. O., Jerry L. M., Capek A., Shibata H. R., Mansell P. W., Lewis M. G., Marquis G. Complications of cancer immunotherapy with levamisole. Lancet. 1977 May 28;1(8022):1129–1132. doi: 10.1016/s0140-6736(77)92386-8. [DOI] [PubMed] [Google Scholar]
  15. 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]
  16. 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. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Rosenthal M., Trabert U., Müller W. Letter: Leucocytotoxic effect of levamisole. Lancet. 1976 Feb 14;1(7955):369–369. doi: 10.1016/s0140-6736(76)90133-1. [DOI] [PubMed] [Google Scholar]
  18. Sands M. J., Jr, Satz J. E., Turner W. E., Jr, Soloff L. A. Pericarditis and perimyocarditis associated with active Mycoplasma pneumoniae infection. Ann Intern Med. 1977 May;86(5):544–548. doi: 10.7326/0003-4819-86-5-544. [DOI] [PubMed] [Google Scholar]
  19. Smith R. A., Nigam B. K., Thompson J. M. Influence of parental age on survival after resection for lung carcinoma. Lancet. 1973 Apr 21;1(7808):843–845. doi: 10.1016/s0140-6736(73)91417-7. [DOI] [PubMed] [Google Scholar]
  20. Symoens J., Rosenthal M. Levamisole in the modulation of the immune response: the current experimental and clinical state. J Reticuloendothel Soc. 1977 Mar;21(3):175–221. [PubMed] [Google Scholar]
  21. Talano J. V. Importance of myocardial antibodies in heart disease. Arch Intern Med. 1977 May;137(5):570–572. [PubMed] [Google Scholar]
  22. Westerhof P. W., van der Putte C. J. Radiation pericarditis and myocardial fibrosis. Eur J Cardiol. 1976 Jun;4(2):213–218. [PubMed] [Google Scholar]

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