THIS WEEK
September 14, 2000
in the New England Journal of Medicine


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Regression of Metastatic Renal-Cell Carcinoma after Stem-Cell Transplantation

The possibility that T cells from a normal person can destroy renal-cell carcinoma was tested in 19 patients with advanced metastatic renal-cell carcinoma. The patients received chemotherapy in doses that did not ablate the bone marrow but were sufficiently immunosuppressive to allow acceptance of an allograft of hematopoietic stem cells from a fully or partially HLA-matched sibling. After transplantation, all patients had circulating T cells of donor origin. Tumor regression occurred in 10 of the recipients.


Absence of Cardiac Toxicity of Zidovudine in Infants

There is concern that antiretroviral therapy with zidovudine may have adverse cardiac effects in infants. In this study, serial echocardiograms were obtained in infants who had been exposed to zidovudine during the perinatal period because their mothers (and in some instances, the infants themselves) were positive for the human immunodeficiency virus. There was no evidence of cardiac toxicity in this group of infants. The data are reassuring, but the study was small, and follow-up was short.

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A Trial of a Supplemental Dose of Four Poliovirus Vaccines

Some infants in developing countries do not have a response to the oral poliovirus vaccine, particularly the type 3 component. In a randomized trial involving 785 infants in Oman, a supplemental dose of inactivated-poliovirus vaccine given subcutaneously at 9 months of age improved the antibody responses; seroprevalence for type 3 increased from 87.8 percent at enrollment to 97.1 percent at 30 days. In contrast, in three groups of infants who received supplemental doses of oral poliovirus vaccines, there was no improvement in antibody responses.


Polymorphisms in the Factor VII Gene and the Risk of Myocardial Infarction

Coagulation factor VII is believed to have a role in precipitating coronary thrombosis. Certain polymorphisms of the gene encoding factor VII are known to influence the circulating levels of this factor. In this study, the presence of either of two polymorphisms in the factor VII gene (designated R353Q and 5'F7, the latter an insertion in the promoter region) was associated with a reduced risk of myocardial infarction in patients with coronary artery disease. This finding adds these polymorphisms to the list of genetic factors that influence the risk of coronary events.