Determination of intramyocardial lactate dehydrogenase (LDH) and its isoenzymes (LDH 1 to 5) has been conducted on biopsy material obtained from the right ventricle in 18 patients who had received the theoretical maximal dose of anthracyclines. Total LDH activity, expressed in mU/mg of myocardial protein is higher (852.61 +/- 87.98) than in subjects with good left ventricular function (334 +/- 208), p less than 0.02. The activity of LDH 1 is decreased in the treated group, whereas that of LDH 3,4 and 5 is raised: LDH 1 = 41.95 +/- 7.25 per cent instead of 47.76 +/- 7.93 per cent (p less than 0.03); LDH 3 = 15.34 +/- 5.09 per cent instead of 9.18 +/- 4.56 per cent (p less than 0.05). The H/M ratio (H = fractions of heart isoenzymes; M = fractions of muscle isoenzymes of LDH) is decreased in the treated group: H/M = 4.06 +/- 1.13 instead of 5.30 +/- 1.80 (p less than 0.01). When the histological lesions are minimal (stage 1 or 1.5 of Billingham), the H/M ratio is not altered: 4.92 +/- 1.02. When the lesions attain or exceed stage 2, the H/M ratio is significantly decreased: 3.74 +/- 0.82. These results, which indicate an increase in anaerobic metabolism, add quantitative information to the histological study.

A phase II study of spirogermanium was conducted in a series of 15 patients with metastatic prostatic carcinoma. All the patients have previously received multiple hormonal therapies. The drug was administered at the dose of 200 mg/m2 by a continuous infusion for five days, and 120 mg/m2, three times a week subsequently. The side effects were mainly neurological toxicity and phlebitis at the injection points which were dose and schedule dependent. Only one partial response for two months was noted in this series. Thus, spirogermanium seems to have a limited value in patients with prostatic cancer.

Pulmonary toxicity associated with chemotherapy is still rare, but its incidence may increase with intensive and iterative regimens. Following a review of the four main drugs responsible for lung toxicity (bleomycin, methotrexate, busulfan and BCNU), the authors underline the risk of combined chemotherapy and radiotherapy. To recognize, at an early stage, the signs suggesting lung toxicity is essential to reduce its extent and, above all, to exclude other pathologies which often have the same clinical and radiological features. Only histological studies provide evidence of toxicity. Treatment is frequently disappointing; the only hope of regression lies in withdrawal of the responsible drug and corticosteroid therapy.

Autologous bone marrow transplantation (ABMT) is a new technique which is currently being evaluated in the treatment of leukemias, lymphomas, and a few solid tumors. In patients with acute leukemia (AL), high dose therapy + ABMT is of little benefit if done at time of relapse. On the other hand, when used for consolidation of remission, either with cleansed or non cleansed marrow, it may improve disease-free survival. In patients with acute myelocytic leukemia (AML) autografted during their 1st remission, the probability of remaining in remission at 2 years is 70 p. 100. It is slightly lower for patients with acute lymphocytic leukemia (ALL): 55 p. 100. The different techniques of cleansing the marrow, monoclonal antibodies, immunotoxins, drugs, are reviewed in this paper. A comparison of these techniques in term of tumor log cell kill is provided. ABMT is the best second line therapy for non-Hodgkin lymphomas (NHL), either after relapse after conventional chemotherapy or partial failure (partial remission). In these patients, the probability of remaining in remission at 3 years is about 50 p. 100. ABMT is currently under trial in the treatment of solid tumors and some success has been obtained in carcinoma of the ovary, non-seminomatous tumor of the testis, neuroblastoma, and some selected breast cancers.

One case of invasive aspergillosis in patient with myeloblastic leukemia probably induced by chimiotherapy is reported. Aspergillosis is a severe infection in immunodepressed host with 70 to 80% of mortality. Early diagnosis can be often carried by broncho-alveolar lavage, route of entry is always pulmonary one. Rapidly established antimycotic treatment can avoid death. Laminar air flow rooms and air spores numeration allow prevention of this infection in the immunodepressed host.