Summary
Ten of 159 patients showed arthritic symptoms during the course of BCG immunotherapy for advanced cancer. The arthritic symptoms occurring after BCG injections had the following characteristics: (1) The incidence of arthritis was closely correlated with the host immunologic responsiveness to BCG; (2) These symptoms usually occurred 1–5 months after the first BCG injection (7/10); (3) The arthritic symptoms usually started with morning stiffness (9/10), which was followed by acute inflammatory signs in the affected joints. They gradually subsided in response to treatment with nonsteroid antiinflammatory drugs, but were not completely cured while the effectiveness of BCG continued; (4) The symptoms were aggravated by additional BCG injections (8/10). (5) This form of arthritis could be differentiated from rheumatoid arthritis, tuberculous, or purulent arthritis by its clinical course and by roentgenograms of the affected joints. It is thought to be induced by the adjuvant effect of BCG, and is a new side effect of BCG immunotherapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aungst, C. W., Sokal, J. E., Jager, B. V.: Complications of vaccination. Proc. Am. Assoc. Cancer Res. 14, 108 (abstract) (1973)
Bodurtha, A., Kim, Y. H., Laucius, J. F., Donato, R. A., Mastrangelo, M. J.: Hepatic granulomas and other hepatic lesions associated with BCG immunotherapy for cancer. Am. J. Clin. Pathol. 61, 747 (1974)
Foucard, T., Hjelmstedt, A.: BCG-osteomyelitis and -osteo-arthritis as a complication following BCG-vaccination. Acta Orthop. Scand. 42, 142 (1971)
Gutterman, J. U., Mavligit, G., McBride, C. M., Frei, E., III, Hersh, E. M.: BCG stimulation of immune responsiveness in patients with malignant melanoma. In: Recent Results in Cancer Research, Vol. 47, p. 476, Berlin: Springer 1974
Gutterman, J. U., Mavligit, G. M., Burgess, M. A., Cardenas, J. O., Blumenschein, G. R., Gottlieb, J. A., McBride, C. M., McCredie, K. B., Bodey, G. P., Rodriguez, V., Freireich, E. J., Hersh, E. M.: Immunotherapy of breast cancer, malignant melanoma, and acute leukemia with BCG: Prolongation of disease-free interval and survival. Cancer Immunol. Immunother. 1, 99 (1976)
Mathé, G., Pouillart, P., Lapeyraque, F.: Active immunotherapy of L 1210 leukaemia applied after the graft of tumor cells. Br. J. Cancer 23, 814 (1969)
Morton, D. L., Eilber, F. R., Malmgren, R. A., Wood, W. C.: Immunological factors which influence response to immunotherapy in malignant melanoma. Surgery 68, 158 (1970)
Pearson, C. M.: Development of arthritis, periarthritis and periostitis in rats given adjuvant. Proc. Soc. Exp. Biol. Med. 91, 95 (1956)
Sparks, F. C., Silberstein, M. J., Hunt, J. S., Haskell, C. M., Pilch, Y. H., Morton, D. L.: Complications of BCG immunotherapy in patients with cancer. N. Engl. J. Med. 289, 827 (1973)
Sparks, F. C., Highton, A., Hunt, J. S., Schoinick, P.: Generalized cutanous reaction associated with the intratumor injection of BCG. Chest 68, 725 (1975)
Tachibana, T., Ishikawa, M.: Quantitation of T and B lymphocyte. Jpn. J. Exp. Med. 43, 227 (1973)
Torisu, M., Sonozaki, H.: Adjuvant arthritis in monkey. Paper presented at the Second International Congress of Immunology, Brighton, England. Brent, C., Holborow, J. (eds.) Progress in Immunology, Vol. 5, p. 294. Amsterdam, London: North Holland Publ. Co. 1974
Torisu, M., Fukawa, M., Nishimura, M., Harasaki, H., Kai, S., Tanaka, J.: Immunotherapy of cancer patients with Bacillus Calmette-Guérin: Summary of four years of experience in Japan. Ann. NY Acad. Sci. 277, 160 (1976)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Torisu, M., Miyahara, T., Shinohara, N. et al. A new side effect of BCG immunotherapy — BCG-induced arthritis in man. Cancer Immunol Immunother 5, 77–83 (1978). https://doi.org/10.1007/BF00199980
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00199980