Tumor necrosis factor-alpha (TNF-alpha) has been implicated in the pathophysiology
of the systemic inflammatory response syndrome (
1
,
2
). This syndrome is often associated with acute hepatic failure, in which TNF-alpha
has also been reported to play a central role (
3
). The systemic use of TNF-alpha in cancer patients is limited by the high incidence
of side effects, whereas the therapeutic effect of acceptable doses remains poor (
4
). Only with TNF-alpha perfusion of isolated limbs is there both a good tumor response
and tolerable systemic side effects after intensive wash-out of the TNF-alpha (
5
). Isolated liver perfusion with TNF-alpha is under investigation for the treatment
of unresectable liver tumors (
6
). Eight isolated liver perfusions with TNF-alpha have been performed at our institution.
We describe our experience with a unique case of accidental high TNF-alpha release
into the systemic circulation after insufficient wash-out.To read this article in full you will need to make a payment
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References
- Anticytokine strategies in the treatment of the systemic inflammatory response syndrome.JAMA. 1993; 269: 1829-1835
- Systemic inflammatory response syndrome.Br J Surg. 1997; 84: 920-935
- Role of lipopolysaccharide and tumor necrosis factor-alpha in induction of hepatocyte necrosis.Am J Physiol. 1995; 269: 297-304
- Tumor necrosis factor.J Clin Oncol. 1989; 7: 291-294
- Isolated limb perfusion with tumor necrosis factor and melphalan for limb salvage in 186 patients with locally advanced soft tissue extremity sarcomas.Ann Surg. 1996; 224: 756-765
- Use of tumor necrosis factor in isolated hepatic perfusion.Circ Shock. 1994; 44: 45-50
Article info
Publication history
Published online: August 16, 2004
Accepted:
June 8,
1998
Received in revised form:
June 8,
1998
Received:
April 6,
1998
Identification
Copyright
© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
