This study assessed the efficacy, toxicity, and pharmacology of low-dose amphotericin B given prophylactically to patients (serum concentrations of 0.2-0.4 microgram/ml) undergoing bone marrow transplantation. Yeast isolates from patients' oropharyngeal areas had MICs of 0.1-0.2 microgram/ml, and none were amphotericin B resistant. The effect of low-dose amphotericin B on reducing the numbers of yeast colonizing the oropharyngeal area was significant (P less than .01). The average delay in switching to high-dose prophylactic amphotericin B was only 1 day; the decision to do so because of a perceived fungal infection occurred more frequently for the placebo group (P = .06). Fewer patients from the low-dose amphotericin B group (8.8%) than from the placebo group (14.3%) had fungi isolated from normally sterile body sites (P = .35). Infusion-related side effects but not systemic toxicities were significantly greater (P less than .001) in the amphotericin B group. The 6-week survival was greater in those receiving amphotericin B (P less than .03), but the improved survival could not be attributed to the prevention of fungal infections.

Time trends for growth, body weight, survival and tumor prevalences in 144 diet control groups with a total of 5,184 male F344/N rats and 146 diet control groups with a total of 5,289 female rats ofNCI-NTP 2-yr chemical carcinogenicity studies started during an ll-yr period (1971 to 1981) in 11 toxicology testing laboratories were evaluated. Male and female rats in more recent studies grew faster and attained a higher body weight than rats from earlier studies. Survival of males showed a significantly decreasing trend over time, which may have been related to diseases associated with increasing body weight, prevalence ofleukemia and changes in criteria for euthanasia of moribund animals. The time trend for survival of females was not significant. There were highly significant(p < 0.001) positive time trends for prevalences ofleukemia, anterior pituitary tumors and thyroid C-cell tumors in both sexes, adrenal pheochromocytomas in males and mammary tumors and endometrial stromal polyps in females. The prevalence of mammary tumors in females and pituitary tumors in males had a highly significant (p < 0.01) positive association with body weight. Histological reevaluation of tumor prevalences in approximately 250 rats of each sex at each of 4 different time periods indicated that changes in diagnostic criteria may have contributed to but could not totally explain the increased prevalence ofleukemia. Changes in diagnostic criteria and the amount of tissue examined may have contributed to the increased prevalence of anterior pituitary tumors in both sexes and adrenal pheochromocytomas in males. Interlaboratory variability and changes in diet may also have contributed to the time-related trends.

Five categories of evidence of carcinogenicity in rats and mice were used to group interpretative results on 86 chemicals studied in recent carcinogenicity tests carried out by the National Toxicology Program (NTP). Of these studies, 50% (43/86) were regarded as showing carcinogenic effects, 42% (36/86) gave no evidence of carcinogenicity, 6% (5/86) showed equivocal evidence of carcinogenicity, and 2% (2/86) were regarded as inadequate experiments. The liver was the most frequent site of cancer in male and female Fischer-344 rats and in male and female B6C3F1 mice. Male rats appeared more sensitive than female rats to the induction of neoplasia, while for mice the females seemed more responsive. The routes of administration yielding the highest percentage (80-83%) of positive studies were gavage and inhalation; approximately one-third of the feed, drinking water, and dermal studies showed carcinogenic effects. In feeding studies, overall survival in dosed and control groups were similar, while the majority of gavage studies showed significantly reduced survival in one or more dosed groups relative to the corresponding controls. The overall percentage of studies showing carcinogenic effects (50%) agrees closely with the rate reported by other investigators for nearly 200 earlier carcinogenicity experiments conducted by the National Cancer Institute.

Time trends for growth, body weight, survival and tumor prevalences in 121 diet control groups with a total of 4,636 male B6C3F1 mice and 123 diet control groups with a total of 4,758 female mice of NCI-NTP 2-yr chemical carcinogenicity studies started during a 9-yr period (1973 to 1981) in 11 laboratories were evaluated. Male and female mice did not show substantial changes in growth patterns. Both sexes had highly significant time trends with decreasing body weights in the more recent studies. This apparent trend was due to high body weights during the first 3 yr and highly significant interlaboratory variability. Time trends for survival of both sexes were not significant. Prevalences ofliver tumors, lung tumors, and lymphoma in males and lung tumors in females did not show significant time trends. There were significant positive time trends for prevalences ofliver tumors and lymphoma in female mice, but the trends were not significant when adjusted for interlaboratory variability. The positive time trend for anterior pituitary tumors offemales was highly significant and may be due in part to an increase in the amount of pituitary tissue examined in the more recent studies. Histological reevaluation of liver and anterior pituitary tissue in 208-249 female mice at each of 4 different times periods did not substantially change the prevalences or the time trends. The major factor influencing time trends in mice appeared to be interlaboratory variability.

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