title: [Case of malignant melanoma of the external genitalia responding satisfactorily to a combination of local injection of OK-432 and chemotherapy].
abstract: A 59-year-old woman with recurrent malignant melanoma of the vulva has well responded to a combination of immunotherapy and chemotherapy. As an immunotherapy, 10KE OK-432 were injected into the tumor twice a week. Chemotherapeutic regimen consisted of intravenous push of 1 mg vincristine on day 1,100 mg dacarbazine from day 1 through 5 and 50 mg nitrosourea (ACNU) on day 5. This treatment was repeated with 4 week intervals. Before treatment, the patient had a 3 X 3 X 5 cm subcutaneous mass on the left vaginal wall near the introitus. Fifty percent objective reduction of the tumor was achieved 6 weeks after commencement of intralegional immunotherapy and chemotherapy, and the tumor almost disappeared 8 months later. At this time, the treatment was changed to a supportive immunotherapy with intramuscular injection of 1KE OK-432 twice a week. But the tumor began to enlarge 2 months later and the patient is now being treated with the same combination therapy. Major side effects were febrile episodes on the day of intratumor injection of OK-432 and nausea, vomiting during the interval of chemotherapy. Anemia was the main hematologic side effect, but leukocytopenia and thrombocytopenia were not severe. The combination of intratumor injection of OK-432 and chemotherapy seems to be effective for the treatment of malignant melanoma.
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001688:Biological Products / Q000008:administration & dosage*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007267:Injections; D008545:Melanoma / Q000188:drug therapy*; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D010844:Picibanil / Q000008:administration & dosage* / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage; D014846:Vulvar Neoplasms / Q000188:drug therapy*
chemical_list: D000276:Adjuvants, Immunologic; D000970:Antineoplastic Agents; D001688:Biological Products; D008937:Mitomycins; D010844:Picibanil; D016685:Mitomycin; D014750:Vincristine; D003520:Cyclophosphamide