[Dramatic remission of a multiple metastasized melanoma caused by chemo-immunotherapy]

A 47 year old woman underwent excision of a malignant melanoma on the right shoulder. Nine years later she was attacked by intense pain in the back. Computed tomography, bone scans and immunohistochemical study of a liver biopsy specimen revealed metastases from the malignant melanoma in the liver, spleen and skeleton. Her Karnovsky score was 50%. Chemoimmunotherapy given for five cycles consisting of dacarbazine (800 mg/m2 body surface area every 4 weeks) together with ambulatory cytokine therapy (interferon alpha-2b subcutaneously, 5 million I.U. on days 1 and 3 to 7 in the first week, days 1, 3 and 5 in the second and third weeks and interleukin 2.9 million I.U. on days 1 to 5 in the second and third weeks; no treatment was given in the fourth week) raised the Karnovsky score to 90% and abolished the pain. Lactate dehydrogenase activity, originally 3372 U/l, dropped to normal. Computed tomography demonstrated definite shrinkage of the liver metastases and some regression of the splenic and bony deposits. This improvement has now been maintained for a total of eight cycles of therapy.