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Acral lentiginous melanoma (ALM) is a distinct variant of malignant melanoma with a predilection for the soles, palms, and nail beds. This melanoma has characteristic histologic features, and its biologic behavior is similar to that of nodular melanoma. It occurs predominantly in the sixth, seventh, and eighth decades of life, with a peak incidence in the seventh decade for males and in the sixth decade for females. Diagnosis of ALM during the radial growth phase is often difficult, and it may not be recognized initially, but treatment in this phase offers an excellent prognosis. There is a high incidence of regressive changes and desmoplasia in ALM; these changes, together with the anatomic peculiarities of nail beds, palms, and soles as compared with other skin areas, make it difficult to determine the Clark's level and to measure the depth of invasion. Wide local excision with lymph node dissection is recommended for subungual melanomas measuring more than 1.00 mm and for lesions showing severe regression. Volar melanomas less than 1.00 mm deep and those in the radial growth phase with minimal invasion require only wide local excision. Amputation of digits and lymph node dissection are recommended for subungual melanomas, if the melanomas exhibit the vertical growth phase. If there is only radial growth without regressive changes, wide local excision is adequate. Patients with metastasis to lymph nodes at the time of diagnosis usually have shorter survival times than do those without lymph node involvement (P = 0.027). Cancer 52:161‐168, 1983.

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Highly purified melanoma TAA which induce melanoma-related cellmediated immune responses have been further characterized using hyperimmune TAA antisera after affinity chromatography for double immunodiffusion-imrnunoelectrophoresis and indirect immunofluorescence studies. An additional study of antigenic modulation was performed in 23 nonanergic and seven anergic melanoma patients, tested simultaneously with melanoma TAA prepared from primary and metastatic tumors, which had been obtained from one patient a t different time periods. The results of pilot clinical trials are reported, including toxicity, timing and dosage studies in 20 patients and subsequent studies of patients with metastatic melanoma treated a t three separate centers, using a single lot of purified, allogeneic melanoma TAA. The results of these latter studies in 51 patients with Stage 111 (distantly metastatic) melanoma and in five patients with earlier stages of disease indicate that: (1) when the interval from primary therapy to recurrence is greater than one year and when liver, bone and brain are not involved, partial or total clinical regression may be noted in up to 25% of patients with metastatic disease receiving immunochemotherapy; (2) when total regression does occur, the effect usually lasts from one to three years; (3) cytoreductive (debulking) surgery, when possible, in cutaneous, nodal retroperitoneal, and visceral regions may enhance the response to specific active immunochemotherapy, although some debulked patients had less tumor burden and this factor alone may lead to an improved prognosis in patients undergoing any subsequent treatment; (4) when circulating inhibitory factors are modified through preimmunization chemotherapy, an enhanced host response may be seen; and (5) Cancer Serum Indices (CSI) may be useful in predicting recurrence and in following tumor load and response to therapy. Information obtained from these studies suggests the need for further trials to determine the effect of immunization on patients with earlier stages of disease where recurrence rates remain high, and to evaluate the mechanisms of tumor rejection or tumor progression in the face of immune stimulation.Cancer 49:1387-1404, 1982.OR several years, we have worked to identify sep-F arated cell membrane components which produce cell-mediated immune reactivrty. We have studied the separated soluble membrane components from malig- nant tissues and counterpart fetal, and benign and normal adult tissues. Our studies differed from those of others in that we started with carefully washed membrane preparations from washed, counted, viable cells for all of our initial work; and we attempted to find antigens appropriate for immunotherapy rather than immunodiagnosis by identifying only those separated components which induce cell-mediated immune responses in vivo and then in vitro.New advancements in technology have permitted us to perform experiments with a view to helping those who are interested in developing diagnostic or monitoring tests for melanoma. S...

The microsomal desaturase activity of human cancerous and noncancerous tissues was measured in vitro using 1-14C, -11, 14-eicosadienoic and 1-14C-oliec acids as substrates. Tissues used were a case of ovarian cancer, a urinary bladder cancer, a rectal cancer, and a non-specific colonic ulcer with appropriately normal tissues. When 11, 14-20:2 was used as substrate, radioactive tetraene and triene were produced. The tetraene was identified by radio gas chromatography as arachidonic acid (5, 8, 11, 14-20:4), and the triene had a retention time of 5, 11, 14-20:3. Thus, the possibility arises that a delta8 desaturase was involved. In the delta6 desaturase, with the urinary bladder cancerous tissue, the desaturase activity appeared to be decreased in comparison to neighboring tissue, whereas with the colonic cancer tissue, the desaturase appeared to be relatively increased, though the number of samples was inadequate for confidence.