In 1980, a consensus chemotherapy intergroup study for advanced malignant mesothelioma was initiated based on a collaborative agreement among the Eastern Cooperative Oncology Group (ECOG), the Southwest Oncology Group (SWOG), and the Southeastern Cancer Study Group (SECSG). The purpose of the study was to evaluate cyclophosphamide (500 mg/m2 day 1), imidazole carboxamide (250 mg/m2 days 1 through 5), and doxorubicin (Adriamycin; Adria Laboratories, Columbus, OH) (50 mg/m2 day 1) v cyclophosphamide (500 mg/m2) and doxorubicin (50 mg/m2) in a randomized prospective clinical trial involving 76 fully evaluable patients with advanced stages II to IV malignant mesothelioma. A total of nine responses (12%) were documented, including three complete and six partial responses. There was no significant difference in response duration or survival between treatment arms. Leukopenia (greater than 2,000/microL) was observed in 46% of patients treated with the three-drug combination and 38% of patients receiving the two-drug combination. The variables of performance status 0-1 and the absence of prior chemotherapy/radiotherapy were significant with respect to favorable impact on survival. We conclude, based on the minimal benefit observed, that the combination of cyclophosphamide and doxorubicin with or without imidazole carboxamide does not warrant further investigation in patients with advanced-stage malignant mesothelioma.

A patient with long standing seropositive rheumatoid arthritis developed lymphocytosis which phenotypically involved the cytotoxic/suppressor T‐lymphocyte population. There are 10 reported instances of this new disease entity described as “chronic T‐cell lymphocytosis with neutropenia” or “chronic suppressor T‐cell lymphocytic leukemia.” The disease is characterized by hepatosplenomegaly, neutropenia, and the frequent presence of rheumatoid factor without clinical evidence of rheumatoid arthritis. Splenectomy in our patient, as well as in other instances where undertaken, has been ineffective in alleviating the neutropenia. The peripheral blood lymphocytes in our patient were OKT‐3+, OKT‐5+, OKT‐8+, OKT‐11+, cALL‐, OKT‐6–, TdT–. They possessed ADCC but no NK activity and did not suppress PWM‐induced B‐cell differentiation in spite of the presence of Fc receptor for IgG. Since the lymphocytosis of OKT‐8+ cells appears to be clonal, it is suggested that the disease be designated chronic suppressor T‐cell lymphocytic leukemia.

Eastern Cooperative Oncology Group experience in the clinical application of the Rappaport Classification on Non-Hodgkin's lymphomas (NHL) is reviewed in 670 cases studied since 1972. The diagnoses of institutional pathologists were reviewed by the Pathology Panel and Repository Center for Lymphoma Clinical Studies. Diagnostic agreement in regard to histologic pattern (nodular versus diffuse) was excellent (90%) but was less favorable when concurrence as to both pattern and cell type was assessed (82% in NLDP and 60% or less in other subtypes). Disagreement in regard to NHL diagnosis is related to the complexity of present nomenclature and to the lack of support of pathology activities within cooperative groups. It is suggested that patients entered into group NHL studies be randomized into favorable and unfavorable groups, primarily on the basis of histological pattern.

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We report the presence of a rosette inhibiting factor (RIF) in the plasma of patients with active Hodgkin's disease. This factor suppresses the rosette forming ability of autologous Active T, Total T, and B lymphocytes with sheep red blood cells, and tends to disappear when clinical remission is achieved. To a lesser extent, the RIF also lowers the Active T, Total T and B-RFC percentages of lymphocytes obtained from normal donors. Although carcinoma and non-Hodgkin's lymphoma patients, as a group, did not exhibit rosette inhibitive properties, certain individuals with these diagnoses did show isolated RIF activity. The RIF could be adsorbed out of plasma using peripheral blood lymphocytes (PBL) from normal controls and appears to be a large heat stable molecule which does not affect PBL viability.Cancer 44:106-111, 1979.