Antibody-Based Therapies
David E. Thurston, Ilona Pysz in Chemistry and Pharmacology of Anticancer Drugs, 2021
It has long been known, but is now increasingly appreciated, that tumor cells can be recognized by the immune system. However, most current cancer therapies do not utilize the body’s innate immunological defense mechanisms. Early in their development, some tumors show evidence of spontaneous regression suggesting that the immune system may be capable of recognizing and eliminating early-stage tumor cells. Observation of this phenomenon led to the foundation of the area of immuno-oncology (IO). It is now known that, in some cases, the immune system is capable of completely eliminating a tumor. For example, spontaneous remissions have been observed in advanced melanoma, adenocarcinoma of the kidney, and urothelial carcinomas. A spontaneous remission is a reduction in severity of, or disappearance of, the signs and symptoms of a disease, without any apparent cause and in the absence of treatment. This spontaneous healing process has been observed in most forms of cancer but most frequently in embryonal and breast cancer, renal adenocarcinoma, neuroblastoma, melanoma, and sarcoma or carcinoma of the bladder. Spontaneous remissions are most often noted in patients who have recently had acute infections, especially when this results in fever which appears to stimulate the immune system.
Endocrinology and gonads
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
11.6. A 14-year-old girl has a smooth, non-tender goitre without any other symptoms. Investigations show T4 87ng/l (normal 85-160), TSH llng/1 (normal 2-3.5) and antimicrosomal antibody titre 1/12 500 (normal less than 1/100). Which of the following statements is/are correct?She has compensated hypothyroidism.This presentation of thyroid disease is rare in teenage children.Spontaneous remission of this condition has been observed.Other endocrine abnormalities may also be found.The most likely diagnosis is Graves' disease.
Topic 11 Consultation Liaison Psychiatry
Melvyn W.B. Zhang, Cyrus S.H. Ho, Roger C.M. Ho, Basant K. Puri in Get Through, 2016
Management of antidepressant-induced sexual dysfunction A thorough history should be taken with regard to the sexual dysfunction, to exclude potential physical health condition as a contributing factor.Some of the common physical health factors that could lead to sexual dysfunction include diabetes and cardiovascular disease.At times, psychological and relationship factors are linked to sexual-related dysfunction as well.It should be noted that, at times, there might be spontaneous remission, whereas in a small proportion of the cases, there might be partial remission.
Delayed therapy initiation for a case with congenital leukemia with transient spontaneous regression
Published in Pediatric Hematology and Oncology, 2022
Kosuke Tamefusa, Satoshi Sunada, Yusei Nakata, Hirokazu Agawa, Ritsuo Nishiuchi
Congenital leukemia is an extremely rare disorder that is diagnosed within the first 28 days of birth.1 Common clinical features of congenital leukemia include prominent hepatosplenomegaly and a high incidence of skin involvement. A distinctive feature of this condition is occurrence of spontaneous remission (SR) in some cases. Congenital leukemia is more commonly of myeloid than lymphoid origin and the optimal treatment strategy remains unclear. Significant chemotherapy-related toxicity has been observed in congenital leukemia.2 We report a case of congenital acute myeloid leukemia (AML) with t(9;11)(p12.3;q23.3);KMT2A-MLLT3. Transient spontaneous regression was observed for 5 weeks and an increased size of residual skin lesions was observed. We administered chemotherapy and induced complete remission without any severe adverse effects. We monitored disease activity so that we could initiate chemotherapy when the tumor burden was maximally debulked and aimed to reduce the toxicity of chemotherapy by delaying the induction of chemotherapy.
Advances in predicting patient survival in pulmonary sarcoidosis
Published in Expert Opinion on Orphan Drugs, 2021
Gamze Kirkil, Elyse Lower, Robert Baughman
Sarcoidosis is a multisystem granulomatous disease with a highly variable natural history. Spontaneous remission is frequent and may occur in up to half of patients, while the remaining cases have chronic, progressive disease, with some patients presenting with life-threatening involvement [1,2]. The outcome largely depends on whether the granulomatous inflammation resolves, either spontaneously or with treatment, or progresses to fibrosis [3]. Approximately 10% of the patients will develop advanced pulmonary sarcoidosis (APS) which is also referred to as ‘high-risk’, ‘treatment-resistant’, or ‘end-stage’ pulmonary sarcoidosis [4]. Some risk factors for the development of APS include ancestry, dyspnea on presentation, need for corticosteroid usage within the first six months after diagnosis, lung infiltration, and the absence of lymphadenopathy on chest imaging [5,6]. Cardiac disease can also lead to death in sarcoidosis [7,8]. However, studies from both the United States and Europe have found that the risk of dying from cardiac sarcoidosis is lower than previously reported, mostly due to the aggressive use of implantable cardiac devices [9,10]. For this review, we will focus only on identifying features predictive of death from pulmonary sarcoidosis.
Advances in understanding and treatment of scleromyxedema
Published in Expert Opinion on Orphan Drugs, 2018
Laura Atzori, Caterina Ferreli, Franco Rongioletti
The disease has no significant race or gender predilection, and involves mainly adults in their five to six decade of age [1,4]. Natural course is hardly predictable, but major case collections document a chronic disabling progression, with sudden systemic complications threatening patient’s life [1,4,6–8]. Spontaneous remission remains anecdotal [6]. The mean time from the onset of the first symptom to diagnosis varies from 10 to 41.6 months [1]. Considering the two major case collections reporting the datum, the mortality rate has decreased from 38% in the Mayo Clinic series (10/26 patients) to 23.8% in the multicenter European study of Rongioletti et al. (5/21 patients). Time periods from the first study publication (1995) and the latter (2013) suggest the importance of changes in management, with current early high-dose immunoglobulin administration, and limited use of very toxic drugs, such as melphalan, which were gold standard treatment previously [1,8]. Besides, therapeutic response to any treatment is not permanent, and prognosis remains guarded for both complications related to scleromyxedema (dermatoneuro syndrome, hearth failure, extensive pulmonary, and renal involvement) and comorbidities (hematological malignancies and septic complications) [1,8–13].
Related Knowledge Centers
- Carcinoma
- Haematopoietic System
- Melanoma
- Palpation
- Leukemia
- Neuroblastoma
- Cancer
- Apoptosis
- Tumors of The Hematopoietic & Lymphoid Tissues
- Lymphoma