The authors report two cases of multiple cancers (three and four) and precise the criterions of multiplicity of cancers, their frequency and their localizations. The factors incriminated in multiple carcinogenesis, often not well known and complicated, are also studied, such as family ground, age, blood groups, hormones, viruses, immunologic deficiencies and some carcinogenic drugs. Moreover, the actual progress in therapy, leading to the healing of the first tumor, may favour the secondary supervening of one or more cancers, as the survival is longer.

A report of two cases of acute leukaemia discovered during pregnancy. The first was treated from the 24th week with cytosine arabinoside, daunorubicine and vincristine and then rubidazone. Only an incomplete remission was obtained. The pregnancy ended with the birth at the 36th week of a normal child, which remains well at the age of 13 months. The second patient received during the 29th week of pregnancy chemotherapy combining cytosine arabinoside and daunorubicine. Signs of foetal distress appeared at 31 weeks. Delivery took place during the 33rd week in a phase of aplasia. The child was born apparently dead and was resuscitated. A complete remission of the leukaemia was obtained. The child was well at the age of 13 months. A transient neutropaenia was noted at the age of 2 months in both children.

Over the last 10 years 267 treatments with cervical cancer have been treated with chemotherapy in 4 anticancer centers. The analysis of these results shows: 1) 9 per cent of the treatments were discontinued because of clinical and hematological intolerance reactions; these intolerance reactions were responsible for 1 per cent of the therapeutic deaths; 2) an effect on the functional symptoms in 52 per cent of the patients with multiple drug regimens; 3) an objective global response in 18 per cent of the patients treated with single drug therapy (3 regressions greater than 50% out of 6 cases treated with cis-platinum) and in 22 per cent of the patients treated with various associations. Comparison of these results to recent data in the literature confirms: 1) the hope of improving objective results by developing more rational protocols of association, since, for the moment more active drugs are not available; 2) a much more marked chemotherapeutic action on lesions which have not been previously irradiated (statistically significant differences in response). Chemoresistance in cervical cancers may not be as frequent or as insurmountable as generally believed. The role of chemotherapy may be visualized from: 1) the palliative point of view, for efficacy while reducing toxicity); 2) induction sequence in curative treatment programs for advanced local forms with unfavorable prognosis (logical and attractive orientation of therapeutic studies); 3) the point of view of adjuvant treatment which remains to be defined. Rigorous studies are required to assess whether chemotherapy can give eventual long term improvement in high risk cervical cancers.

Toyocamycin (TMC), an adenosine analog, impairs qualitatively and quantitatively virus production in a cellular system chronically infected by Friend Virus. Viral particles released by cell cultures treated with 0.2 microgram/ml of the drug have lost most of their glycoprotein (gp 70) content. This phenomenon is likely to modify the viral envelope and could explain the loss of infectivity of the virus.

Leg paralysis and wallerian degeneration of sciatic nerve fibres have been produced in rats by intraneural injection of 0.5, 1 or 5 microgram of vincristine (VCR) or formyl leurosine (FLR) dissolved in 5 microliter of saline. Nerve lesions were dose-related, and were similar for equal concentrations of the two drugs. Six patients received one to three 5-day courses of FLR. The total dose of FLR administered ranged from 15 to 131 mg (mean 83 mg). Clinical signs of peripheral neuropathy were absent in four patients, and limited to orthostatic hypotension in one case and transient depression of reflexes in another. Motor conduction velocities measured in four peripheral nerves, and muscle evoked potentials remained unchanged throughout the treatment in all patients.

The authors undertook a retrospective study to determine the number of acute leukaemias developing amongst 2006 patients suffering from chronic inflammatory rheumatic conditions and connective tissue disorders, treated with cytotoxic agents. The follow-up period ranged from 1 to 13 years. Nineteen leukaemias were found, essentially granulocytic, with a latent period of 5.7 +/- 2, 8 years after the beginning of treatment. This incidence of almost 1% of leukaemias is probably less than the actual percentage since a number of patients were lost on follow up and since the period of observation is as yet too short. The majority of patients has been treated for more than one year. No cases were seen amongst patients treated for less than six months, or with less than 1g of chlorambucil or 50 g of cyclophosphamide. The risk would seem to be the same for both alkylating agents. No patients treated with azathioprine developed leukaemia, but few patients received this drug. Amongst 35 patients treated for severe psoriatic arthropathy with chlorambucil, 4 developed leukaemia. This particularly high percentage is such that all trials of alkylating agent in this condition should be stopped. The prevalence of leukaemia seen in the series as a whole is comparable to that found in mass studies carried out in various malignant diseases treated by cytotoxics. Awareness of this risk should, lead to even stricter limitations before the use of cytotoxic drugs in rheumatological conditions.