Search

In a multicenter trial conducted with patients suffering from chronic bronchopathy, Biostim, an immunomodulating compound of biological origin has been studied using the double-blind placebo-controlled method for prevention of respiratory tract infections. One hundred and ten patients from 10 french pneumology health centers entered the study. The treatment was administered at random in three sequences of 8 days a month for 3 months (2 mg/day the first month, 1 mg/day the second and third months). Patients were separated into 2 groups regarding severity of the disease: group I (non complicated chronic bronchitis); group II (obstructive chronic bronchitis with or without respiratory failure). Patients were examined during 6 months with a monthly appraisal of number, duration and treatment clinically defined infectious episodes. The study of propensity to infections with respect to severity of the disease in patients given placebo showed a significantly lower number of infectious episodes in group I when compared to group II. In the group I (patients suffering from simple chronic bronchitis), no significant difference could be noted between placebo and Biostim but, at all events, the low frequency of episodes makes it difficult to evidence a protective effect in such a group. In contrast, with patients presenting a high infectious risk (group II), one can observe in Biostim treated patients compared with placebo group a significant decrease of infectious episodes and a larger number of patients standing free of episodes throughout the whole period of trial. Tolerance to Biostim has revealed itself satisfactory.

The authors report a case of severe obliterating laryngo-tracheo-bronchitis without any evident etiology in a young patient with depressed immunity. A herpetic virus was isolated by distal bronchial brushing and by larynx biopsy. The level of specific antibodies rose significantly. These facts together with the clinical history and unsuccessful microbiological searches, suggest the herpetic nature of this affection, albeit exceptional. At this opportunity, a review of the literature is presented showing the imprecision of diagnostic criteria in this field of pathology.

Thirty patients with measurable tumors of known spontaneous doubling time were treated by CCNU 75 mg/m2 every 3 weeks. Hematopoietic toxicity was minimal with this original schedule. Efficacy has been judged on therapeutic growth curves. Complete response occurred in 3 cases (10%), partial response over 50% in 2 (7%), partial response between 50 and 25% in 3 (10%), static response in 12 (40% with a median duration of 4 months), significant slowing down in 3 (10%) and total failure in 7 (23%). In 9 cases resistance, as judged by the resuming of the previous growth rate despite the treatment, occurred after a median duration of 1·5 months. The analysis of the data shows that: (a) this model allows the detection and measure of weak responses that are overlooked by the usual trials though they may be of great benefit to the patients in terms of survival gain; (b) in all responders the response is seen within one week after the beginning of the treatment; (c) maximal response has been always obtained before the time of the third dose; (d) maximal response and onset of total resistance follow in close succession (1 month); (e) there is no correlation between spontaneous growth rate and the degree of response. These unexpected findings show that resistance plays a more important role with this drug than non-proliferating cells as a limiting factor. These findings are discussed in view of the strategy of chemotherapy.