Cancer March-April (950
274
pucing the diluuon of the Cr°-tagged cells in
each sample of cardiac bluod. Determination
of the red-cell mass and approximate plasma
volume was made from hematocrits of the
samples.
Additional studies were undertaken to de-
termine the fate of Cr*! at one and sixteen
Expressed as PerCent ofwet per Organ and
—
Adrenals
0 007
Nonefemur, tibia, Bbula) 10
Kidneys
Lot
Gastrointestinal tract
2.26
tthe tissues examined but was slowly and con-
Muscle
tinuously excreted in the urine and to same
skin
that the administration of tracer doses of Cr®
Balance
small amountof radiation received would not
be localized in any tissue but would be shared
—
Birat24
Human Studies. The yed-cell mass, plasma
216-432
extent in the feces. These results indicated
Bioog.
would not be hazardous to patients, since the 7i3,"h,
by the whole body.
ae eee
ad
Na
ae ndluon ae
«ee
=
~
ego»
unequivocal clinical and laboratory (including
roenigenographic) findings, surgical exploration, biopsy, and autopsy. For purpoeca of
evaluation, the cases were divided by the same
criteria into cancers with extensive spread
(106 cases) and nonmetastatic cancers (twenty:
i
cig
| 4 h
Tau|
DEPOSITION OF CARRIER-FREE Na,Cr“0, IN
THE RAT ONE AND SIXTEEN DAYS AFTER
INTRAMUSCULAR INJECTION
yh
/."
Values Are Expressed 8 WeWeghe TheueePed
:
—
pas f
4
fl
i!
{‘
i ia
A
{
Theue
Heart
Spleen
Me: we
lp at
rd
«
Bet M
i
Poche }
Ub eh at eg. i
ae ae
4)
aki t. ee
eens ;
t 7 ae ,
ARSE Ue i
4
+
4
9.70
B.o
is
prmoa¢
old7 “ah
Brain
‘
Ons ey?
Muacie
Feces
Om
Veale at.
Tavernge veluee ol Uhren rete.
9.0¢
0.04
%,urine
—
oe
10.6
3.6
es
-
ON
y = Zdev.# (for group1) + Yew? (for group 2).
(a) + (ns — 2)
J,feces
—
wl
09.9
.
table for ¢.
tagged bt
ufephosl sunilar to that used in the
Beparinized bleod (B to 10 ¢c)
was seeded with known amounts ol sodium
htomate and shaken on a mechanical agitator
tor atleast forty-five usimates. Phe plasma was
withdrawn and the cell ins washed twhe
=
4
a9
B08
found in the patients with leukemia, carci-
noma of the stomach and esophagus, and
carcinoma of the colon (P = 0.02, <0.01, and
<0.01 respectively).
In all of the various categories of cancer
shown in Table 4, the red-cell masses were
lower than normal and the plasma volumes
greater than normal to a significant degree,
except in the group with carcinoma of the
colon. In these patient, the red-cell mags was
enentially normal.
Hematocrits in all patients with cancer, including those patients with leukemia and
Hodgkin's disease, were lower than normal.
af
Discussion
0.1). No siguiheuat iesease was noted in the
Results of the present gtudy showed that,
whereas the whole-blood volume was not expanded in the presence of a malignant tumor
in man, the plasma volume was significantly
increased. Conversely, greater than normal
volumes were found in tumor-bearing rats.
The average red-cell mass of all cancer patients
was significantly lower than that of normal
subjects, 25.88 cc. per Kg. and 29.6 cc. per Kg.
respectively. A similar decrease was not observed in the experimental rats; however, the
rapid growth of the transmissible amor used
for implantation may have occurred in too
shore a period to interfere appreciably with
hematopoiesis or have much influence on the
existing red cells in the blocd tsueain.
A comparison of the blood volumes of all
of the cancer patients with the controls showed
that the reduction in red-ccll mass was balanced by an expansion of the plasma volume
and resulted in whole-blood volumes that
were approximately normal. These results
‘Vante 3
with normal saline to remove whe Wapped
whole-bloud volumes were sigiubcamily lower
normal saline; a staal aliquot was taken to
including those categorized as being extensive,
tnjected and the remainder given to the pa
aowell as an cxpansion of plasma volume
(P= <0.01). The plasma volumes in the group
With Nonmetastatic cancers were not signiGGently increased (P = 0.3).
Analysis of the data in the groupsclassified
according to the type or location of the preinant tumor showed normal blood vol-
o13
438
uines in the patients with pulmonary cancer
and Hodgkin's disease, whereas significantly
greater than norma) blood volumes were
COMPARISON OF THE BLOOD VOLUMES OF
CONTKOL AND TUMOR-BEARING RATS USING THE Cr RED-CELL-TAGGING METHOD*
033 /
0.36
with cancer, the whole-blood volume was not
significantly diflercnt haom qormal (Vable 4),
67.62 + O.BL vs. 65.5 4 0.70 ce. per Kg. (Poss
275
gloup with extensive metituscs im the pa-
tient intravenously. Earlier studies had shown
ang
Resucts
Animal Studies. The average body weight,
one cases), They were further subdivided acblood volume, and packed-cell volume of the
cording to the location of the tumor as foltumor-bearing vais and their controly are
lows; forty-three pulmonary carcinomas, ninePresented in Table 3. ‘he average wholeteen carcinomas of the colon, hiteen cases of |
leukemia, and thirteen cases of Hodgkin’ qi blood voluine of the twenty-nine tumor-bearing rats averaped 7.1 + 0.25 per cet of the
disease.
body weight. “Vhis was signihcamtly greater
To our knowledge the patients did not have
than that of the controls, which averaged 5.37
other conditions that might expand blood
+ 0.18 per cent of the body weight. The involume, buc manyof them hag anehiis, weight
creased blood volume of the tumor-bearing
loss, and/or dehydration owihg to ehe cancer
fats resulted primarily (row an expansion of
that might have decreased blvod ‘voluine. A
the plasma volume (2 — O40). “Phe red-cell
nuinber of patients had’ layge mahguant uu
Mass Was incicascd sliptily.
mors with widespread metastases.
Human Studies. In the majority of patients
Thyging of Hed Cell. Human ied cells were
tests on fads.
Reilly, Helwig & Scott
The value for Fisher's « = CED .
The probability: gf any dilterence between
groups was obtdifed by using a standard
2.3
8%
Oe8
=.
The sandard e:rer of difterencé = Jeg.
1
78
oa
3.08
Hematocrita were made in order to calculate
the relative plasma volumes aud the red-cell
mass from the whole-blood volume.
by Vie).
‘Whe signilicance of any difference between twa groups was calculated by
finding the variance (v) between groups:
determine the number of Cr! counts to be
8.06
#7
7.87
total counts/aec injected==. apparent
counte/sec./cc., tinal blood sample ~ bluod volume.
The mean + the standard error wae calculated
0.03
0.03
counter. The blood volume was computed as
follows:
All data are expressed as the mean tor any
Oo
1.45
i
Ce® ton BLoup- VOLUME MEASUREMENT
strics Of Observations + the atandard evsor.
ox
7.36
iu
fe |
_
oo
0152
0. 07
oil
an
O34
|
7...)
.
_
% per gm.
plasma, The volume was reconstructed with
eld
1
49-216
23
-
068)
Seb
Smalliotovting 0-68
Gon
Shien dove”
% in organ % pera Kin van Horem
Sas
8.27
B08
ot
oa
9.48
Be
94%
idldaey
Thecokd
ct eal \l
tots
\
volume, and whole-blood volume were de
termined in eighty-seven normal subjects (providing eighty-seven tests) and 175 hospitalized
patients with various types of cancer (providing 218 tests). The presence of a cancer was
confirmed by one or more of the following:
{
Zo inorgan
carrier-free Cr#! (Table |) and at cighteen days
after the intraperitoneal administration of
} mg. of labeled sodium chromate (Table 2).
The data obtained showed that Cr*! was not
localized wo any appreciable extent in any of tary
,
.
No. 2
tagged red cells with a scinuillation crystal
DEPOSITION GF 1 MG. OF Na,CrO, TAGGED
WITH Cr’ IN RATS EIGHTEEN DAYS AFTER
INTRAPERITONEAL ADMINISTRATION
Values Are the Averages of Three Rats. ‘Total Recovery 90.3 Per Cent
Administered Dose. Data An
days after the intramuscular injection of Tissue
t
Vol 9
Taig 2
that one hour allowed adequate time for com-
plete mixing of the tagged cells. At the end
=
of this period another heparinized sample of
“=-
volume of the sample was assayed
blood (5 to 10 cc.) was withdrawn, A measured
for its
Cr*
Hens with nonmetastatic came, however, the
than normal (P= 0.01), All cases of cancer,
showed a significance redaction of red-cell mass,
Rats
Blood vol.,
% body wt.
Tumor-bearing
29)
ange
Contr
(22)
Range
Hematocrit
Av. body
wt, gm,
7.100.25
§$.4-9.5
35.9 0.81
22.0-46.
207,0
5 4«0 18
4.4-7.7
48.1= 0.97
43.0-55.
176.0
“Size of tumors ranged from @ to 35 gm.
Averages given = mean standard estos Jha
.