Cutaneous toxicity after intradermal vaccination with Mycobacterium vaccae against lung cancer and malignant mesothelioma

Our plain-English summary of Cutaneous toxicity after intradermal vaccination with Mycobacterium vaccae against lung cancer and malignant mesothelioma, by H.S. Pandha, P. Mortimer, B. Souberbeille, et al (The British Journal of Dermatology, 2001).

The study

• Authors: H.S. Pandha, P. Mortimer, B. Souberbeille, P. McCoubrie, M.E. O'Brien
• Journal: The British Journal of Dermatology
• Published: 2001;144(3):648-9
• Type of article: Case report, Letter
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter reported two patients at the Royal Marsden Hospital who developed unusual skin reactions after injections into the skin of SRL172, a heat-killed Mycobacterium vaccae vaccine being tested against cancer. The first, a 52-year-old man with pleural mesothelioma in a phase II trial, developed an intensely itchy, non-blanching red rash over both ankles and the tops of both feet six days after his second vaccination. A skin biopsy showed leucocytoclastic vasculitis (inflammation of small blood vessels). The rash appeared to subside on its own. His disease progressed rapidly and he died one month later. The second, a 74-year-old woman with small-cell lung cancer given the vaccine alongside chemotherapy (mitomycin, vinblastine and cisplatin), developed a firm red area in a necklace pattern over her back. Biopsy showed panniculitis with small areas of fat necrosis. The area slowly cleared over two months after treatment stopped. The authors felt the first reaction was a response to the vaccine rather than the mesothelioma. They attributed the second to the vaccine, or to the vaccine combined with chemotherapy. The letter did not discuss asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter describing two case reports
• Who was studied: Two cancer patients at the Royal Marsden Hospital, UK. Patient 1 was a 52-year-old man with pleural mesothelioma enrolled in a phase II trial of monthly SRL172 versus best supportive care. Patient 2 was a 74-year-old woman with small-cell carcinoma of the bronchus, first seen in February 1998.
• Exposure: SRL172, a heat-killed Mycobacterium vaccae vaccine, given as an injection into the skin. Patient 2 also received chemotherapy with mitomycin, vinblastine and cisplatin. Asbestos exposure was not discussed.
• Main results:
  • Patient 1 (pleural mesothelioma) developed a red papular rash over both ankles and the tops of both feet six days after his second vaccination.
  • In patient 1, a skin biopsy indicated leucocytoclastic vasculitis.
  • In patient 1, the rash appeared to subside spontaneously. His disease progressed rapidly and he died one month later.
  • Patient 2 (small-cell lung cancer, on chemotherapy plus SRL172) developed a non-tender, red, hardened area in a necklace distribution over her back.
  • In patient 2, a biopsy showed non-specific panniculitis with small foci of fat necrosis.
  • Patient 2's skin lesions slowly resolved over 2 months after she stopped chemotherapy and vaccination.
• The authors' conclusion: The authors felt the skin changes in patient 1 were a response to the SRL172 vaccine rather than the mesothelioma. They thought the fat necrosis in patient 2 was due to SRL172, or to the combination of chemotherapy with SRL172.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Malignant Mesothelioma.

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