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Tumor Necrosis Factor Induces Hemorrhagic Necrosis of a Sarcoma

Paul A. Robertson, MD; Helen J. Ross, MD; and Robert A. Figlin, MD
[+] Article, Author, and Disclosure Information

Grant Support: Supported in part by the Jonsson Comprehensive Cancer Center, University of California at Los Angeles, California, and by Genentech Inc., South San Francisco, California.

Requests for Reprints: Robert A. Figlin, MD, Department of Medicine, Division of Hematology-Oncology, University of California at Los Angeles, Louis Factor Building, Room 8-950, 700 Tiverton Avenue, Los Angeles, CA 90024.

Current Author Addresses: Drs. Figlin and Ross: University of California at Los Angeles, Medical Center, Los Angeles, CA 90024.

Dr. Robertson: Western Washington Cancer Treatment Center, Olympia, WA 98502.

Ann Intern Med. 1989;111(8):682-684. doi:10.7326/0003-4819-111-8-682
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William B. Coley, MD, a surgeon of the early 20th century, noted the regression of a soft-tissue sarcoma in the neck of a patient after a life-threatening bacterial infection. He subsequently developed Coley toxins (sterilized cultures of various gram-negative bacilli), which he administered to patients with solid tumors to reproduce the antitumor effect he had observed with severe bacterial infections. The search for a pathophysiologic explanation of this phenomenon led Carswell and colleagues (1) in 1974 to describe tumor necrosis factor. This endotoxin-induced serum factor caused necrosis within 24 hours of subcutaneously transplanted methylcholanthrene A-induced sarcoma in BCG-primed mice. The





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