Respiration
Original Paper
Intrapleural Corynebacterium parvum for Recurrent Malignant Pleural EffusionsForesti V.Third Medical Department, Fatebenefratelli Hospital, Milan, Italy
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Article / Publication Details
Received: August 02, 1993
Accepted: August 29, 1994
Published online: January 21, 2009
Issue release date: 1995
Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 0
ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)
For additional information: https://www.karger.com/RES
Abstract
Twenty-two consecutive patients with malignant pleural effusions (MPE) were treated with intrapleural Corynebacterium parvum (CBP) associated with parenteral methylprednisolone (MP) to determine its effectiveness and the frequency and nature of adverse reactions. After thoracentesis, 7 mg of CBP (Coparvax Wellcome) in 20 ml of saline were injected into the pleural cavity. On the day of treatment, the patients were given 1 mg/kg i.m. of MP 30 min before thoracentesis. The effectiveness of pleurodesis was assessed as follows: (1) complete response (CR; total resolution of pleural effusion after 3 injections of CBP at the most); (2) partial response (PR; formation of asymptomatic loculated effusion). In 5 patients leukocytes, lymphocytes and monocytes were determined in pleural fluid (PF) and in blood (B) collected before and 7 days after CBP treatment. Two patients were unevaluable. Of 20 evaluable patients, 18 (90%) had a CR and 2 patients (10%) had a PR. Eleven of 22 patients (50%) had a fever. Three patients had prolonged and/or high fever. Seven of 22 patients (32%) had mild chest pain. None of the patients presented other side effects. Twelve of 21 patients (57.1%) had a PF pH > 7.30; 2 of these died a few days after the treatment, and 10 had favorable responses. The other 9 patients had a PF pH < 7.30: all had favorable responses. The leukocytes, the lymphocyte subsets, the monocytes, the NK lymphocytes, and their PF/B ratios did not differ significantly before and after CBP treatment. Our study confirms that intrapleural CBP is an effective and simple method to control MPE. The combination of MP with CBP did not prevent effective pleurodesis and seems to reduce the frequency of adverse reactions, except fever.
© 1995 S. Karger AG, Basel
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Article / Publication Details
Received: August 02, 1993
Accepted: August 29, 1994
Published online: January 21, 2009
Issue release date: 1995
Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 0
ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)
For additional information: https://www.karger.com/RES
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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