A unique experience with human pre-immune (12 weeks) and hypo-immune (16 weeks) fetal thymus transplant in a vascular subcutaneous axillary fold in patients with advanced cancer: A report of two cases

Background: The successful development of fetal cell/tissue transplantation in adults has resulted in the possibility of eventual therapeutic solution s with a variety of intractable diseases. Umbilical cord whole blood transp lantation appears to be safe in the adult system. In severe forms of DiGeor ge Syndrome, cultured thymus transplant can help in the reconstitution of t he immune condition of the host. Successful fetal tissue transplant in adul ts has raised the hope of future effective gene transplant and its manipula tion prospects to combat many diseases including hemopathies, inborn errors of metabolism, immunodeficiencies and even cancer and AIDS. Materials and Method: Two cases of advanced cancer were treated with fetal (pre-immune 12 weeks and hypo-immune 16 weeks) thymus transplants in subcut aneous vascular axillary folds, which were removed after one month. Thymuse s were collected from consenting mothers undergoing hysterotomy and ligatio n. Results and Analysis: Patient 1 was suffering from non-Hodgkins lymphoma (A nn Arbor Stage IV) and was receiving cyclophosphomide, doxorubicin, vincris tine and prednisolone after a course of radiotherapy; she developed leucope nia (2,400/cmm), which improved after receiving a 16-week human fetal thymi c graft. The leucopenia was eventually over-corrected and the leucocyte cou nt reached 44,000/cmm within a month, which was reversed after the thymus w as taken out. Histology of the excised thymic graft showed growth and proli feration without any graft vs. host (GVH) reaction. Patient 2 was suffering from breast duct carcinoma (T-4, N-2, M-0) with estrogen, progesterone, an d epidermal growth factor negative status, and was treated with modified ra dical mastectomy and axillary clearance followed by chemotherapy with cyclo phosphomide, methotrexate and 5-fluorouracil for six cycles. She also recei ved a 12-week-old human fetal thymus at the contra-lateral axilla which was removed after one month. In this case the peripheral leucocyte count did n ot show appreciable variation as in the first case. However, histology of t he excised thymic graft showed growth and proliferation with an appearance of Hassel's corpuscles. Conclusion: Pre-immune and hypo-immune human fetal thymic transplant is not rejected in patients suffering from advanced cancer within one month (obse rvation period). Thymic lymphocyte shedding in the correction of leucopenia in the background of non-Hodgkin's lymphoma may have many therapeutic impl ications.