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. 1976 Aug;29(8):693–697. doi: 10.1136/jcp.29.8.693

Granuloma formation in patients receiving BCG immunotherapy.

J A Whittaker, D P Bentley, G R Melville-Jones, A J Slater
PMCID: PMC476148  PMID: 1066353

Abstract

Eleven patients with acute myeloblastic leukaemia have received repeated intravenous injections of BCG containing 4-9 X 10(6) live organisms per millilitre. Non-caseating epithelioid granulomas, sometimes with giant-cell formation, have been demonstrated in eight bone marrow aspirates. Seven patients had granulomas in the liver, three in the lung, one in the spleen, one in lymph nodes, and one in a skin biopsy. One patient had a raised serum alkaline phosphatase, but none of the patients had any illness which could be related to the presence of granulomas. Granuloma formation appeared more extensive in four patients who were probably anergic before BCG treatment. Until the significance of this finding becomes clear great care should be taken when giving BCG by the intratumour of intravenous routes to potentially immunoincompetent patients.

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Selected References

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

  1. BONNEVIER J. O., KILLANDER J., OLDING L., VAHLQUIST B. CONGENITAL AGAMMAGLOBULINAEMIA IN THE BROTHER OF A BOY WHO DIED OF GENERALIZED BCG INFECTION. Acta Paediatr. 1964 Jan;53:55–64. doi: 10.1111/j.1651-2227.1964.tb07206.x. [DOI] [PubMed] [Google Scholar]
  2. BOUTON J., MAINWARING D., SMITHELLS R. W. B.C.G. dissemination in congenital hypogammaglobulinaemia. Br Med J. 1963 Jun 8;1(5344):1512–1515. doi: 10.1136/bmj.1.5344.1502. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. 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]
  4. GORMSEN H. On the occurrence of epitheloid cell granulomas in the organs of BCG-vaccinated human beings. Acta Pathol Microbiol Scand Suppl. 1956;39(Suppl 111):117–120. doi: 10.1111/j.1600-0463.1956.tb06761.x. [DOI] [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. Gutterman J. U., Mavligit G., Gottlieb J. A., Burgess M. A., McBride C. E., Einhorn L., Freireich E. J., Hersh E. M. Chemoimmunotherapy of disseminated malignant melanoma with dimethyl triazeno imidazole carboxamide and bacillus calmette--guérin. N Engl J Med. 1974 Sep 19;291(12):592–597. doi: 10.1056/NEJM197409192911202. [DOI] [PubMed] [Google Scholar]
  7. Hunt J. S., Silverstein M. J., Sparks F. C., Haskell C. M., Pilch Y. H., Morton D. L. Granulomatous hepatitis: a complication of B.C.G. immunotherapy. Lancet. 1973 Oct 13;2(7833):820–821. doi: 10.1016/s0140-6736(73)90860-x. [DOI] [PubMed] [Google Scholar]
  8. Muggleton P. W., Prince G. H., Hilton M. L. Effect of intravenous B.C.G. in guineapigs and pertinence to cancer immunotherapy in man. Lancet. 1975 Jun 21;1(7921):1353–1355. doi: 10.1016/s0140-6736(75)92261-8. [DOI] [PubMed] [Google Scholar]
  9. 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]
  10. STROM L., WIDSTROM G. Quelques expériences concernant l'immunité antituberculeuse, effectuées à l'aide de bacilles radio-actifs. Acta Paediatr. 1951 May;40(3):213–217. doi: 10.1111/j.1651-2227.1951.tb16496.x. [DOI] [PubMed] [Google Scholar]
  11. Sparks F. C., Silverstein M. J., Hunt J. S., Haskell C. M., Pilch Y. H., Morton D. L. Complications of BCG immunotherapy in patients with cancer. N Engl J Med. 1973 Oct 18;289(16):827–830. doi: 10.1056/NEJM197310182891603. [DOI] [PubMed] [Google Scholar]
  12. 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]
  13. WALLGREN A. Should mass vaccination with BCG be discontinued in Scandinavia? Acta Paediatr. 1955 May;44(3):237–253. doi: 10.1111/j.1651-2227.1955.tb04136.x. [DOI] [PubMed] [Google Scholar]
  14. Whittaker J. A., Lilleyman J. S., Jacobs A., Balfour I. Letter: Immunotherapy with intravenous B.C.G. Lancet. 1973 Dec 22;2(7843):1454–1454. doi: 10.1016/s0140-6736(73)92859-6. [DOI] [PubMed] [Google Scholar]

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