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The therapeutic problems raised by recurrences are different from those which apply to the initial malignant glioma. Firstly, the histological diagnosis is known (by excision or biopsy) and secondly the clinical period which has elapsed before the recurrence represents a factor in the assessment of progression and/or malignancy. The management of treatment must take into account various parameters of an anatomical and clinical nature, but although those relating the various forms of treatment used already. Although the methods used are the same: surgery, radiotherapy, chemotherapy, the strategy will differ according to indications of final recourse or reoperation will be discussed after initial surgery followed by radiotherapy, irradiation in those cases in which radiotherapy has not already been used and chemotherapy, Corticosteroids are also widely employed. Whilst such palliative treatment has the merit of ensuring prolongation of survival, the principal aims must be concerned with the quality and conditions of this survival.

A histological study of lymphocytic infiltration has been undertaken following removal at operation of one hundred human gliomas. This study has been completed with eight cases of tumour recurrence, six attempted autologous grafts, twenty one post-mortems and fourteen explorations of delayed hypersensitivity reactions. About half of the glioma specimens showed lymphocytic infiltration and no reaction was present in the other. Within this series of glioblastomas a correlation existed between the presence of infiltrating lymphocytes and the duration both of pre and post operative tumour evolution. The rejection of autologous grafts seemed to depend directly on the presence of lymphocytic infiltrations associated with the primary tumour. The retarded hypersensitivity reactions obtained after intradermic inoculations of cellular lyophilizates did not seem to be directly related either to the phenomenon of autologous graft rejection or to the presence of lymphocytic infiltrations. The results suggest that there is a complex system represented by two antigenic groups of transplantation type and sensitization type.

Three cell lines derived in our laboratory from human malignant gliomas (SA 130, SA 132, SA 134) were injected subcutaneously into pathogen-free nude thymus less mice. These three cell lines gave origine to malignant tumors which, as original tumors, were positive for the glial fibrillary acidic protein (GFAP) revealed by immunoperoxidase method.