Immunotherapy of localized, intermediate, and diffuse forms of American cutaneous leishmaniasis.

Abstract	The clinical efficacy of immunotherapy for localized American cutaneous leishmaniasis with a combination of heat-killed Leishmania mexicana amazonensis promastigotes and viable BCG (bacille Calmette Guérin) has been compared with meglumine antimoniate chemotherapy and with BCG alone in a controlled clinical study in 217 patients. The results in the first two groups were comparable, with greater than 90% clinical cures with an average time of 16-18 w required for healing. The cure rate was considerably lower (42%) and more prolonged in the group receiving BCG alone. Secondary effects were observed in less than 5% of the patients receiving combined immunotherapy or BCG alone. In contrast, 49% of the patients receiving chemotherapy showed side effects. High therapeutic efficacy was also observed using combined immunotherapy in patients with intermediate and diffuse cutaneous leishmaniasis who were previously unresponsive to chemotherapy. Cure or clinical improvement was seen in all 11 patients with intermediate forms of the disease, and marked clinical improvement was observed in 9 of 10 patients with diffuse disease. The results on the efficacy of the combined vaccine in immunotherapy for American cutaneous leishmaniasis provide a strong rationale for studying its effectiveness in prophylactic trials.
Authors	J Convit, P L Castellanos, M Ulrich, M Castés, A Rondón, M E Pinardi, N Rodríquez, B R Bloom, S Formica, L Valecillos
Journal	The Journal of infectious diseases (J Infect Dis) Vol. 160 Issue 1 Pg. 104-15 (Jul 1989) ISSN: 0022-1899 [Print] United States
PMID	2659679 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References	BCG Vaccine
Topics	Adolescent Adult Animals BCG Vaccine (therapeutic use) Clinical Trials as Topic Combined Modality Therapy Female Humans Immunotherapy Leishmania mexicana (immunology) Leishmaniasis (drug therapy, therapy) Male Microscopy, Electron Microscopy, Electron, Scanning Middle Aged Random Allocation Skin (parasitology, ultrastructure)

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