The use of BCG, adoptive transfer, and neuraminidase treated tumor cells in the management of melanoma
BCG immunization in 193 patients proved successful for the stimulation of delayed cutaneous hypersensitivity to PPD. The data tends to refute the hypothesis that BCG immunization brings about a general augmentation of delayed cutaneous hypersensitivity. Furthermore the results indicate that BCG is most effective if the patient is rendered immune to this delayed allergen by prior sensitization. After the patient becomes skin test positive to PPD, intralesional injection with BCG produces a local delayed hypersensitivity response with a partial or complete necrosis of the tumor nodule. Other workers have also reported that direct contact between BCG and the tumor is essential for optimum anti tumor effect. This may explain the failure of the authors' regimen to produce regression of visceral, bone and central nervous system metastases. Febrile reactions and occasional flu like syndromes following intralesional injection of BCG have been observed, but no severe reactions or contraction of tuberculosis as has been reported by other workers were seen here. The use of x irradiated, neuraminidase treated tumor cells plus BCG has produced tumor regression in patients that failed to respond after completing Stages I and II of the immunotherapy regimen.
