Composite Hodgkin's and non-Hodgkin's lymphoma in a patient with acquired immune deficiency syndrome: in-situ demonstration of Epstein-Barr virus

Article Abstract:

A 44-year-old man infected with the AIDS virus was found to have both Hodgkin's and non-Hodgkin's lymphomas. This condition is quite uncommon, and it is usually supposed that affected individuals must have some predisposition to the development of lymphoma. Since previous research has demonstrated that some lymphomas are associated with the presence of genes from the Epstein-Barr virus (EBV), examination of the two disparate lymphomas of this patient was undertaken to look for evidence of EBV genes. The researchers used the technique of in-situ hybridization, in which labelled probes for EBV genes are incubated with tissue sections. Cells containing the genes, which are complementary to the probes, will bind to the probes and hence be labelled. Examination of the slides permits direct identification of the cells which have bound to probe molecules and have the viral genes. In this particular case, evidence of EBV genes was found in the cells of the non-Hodgkin's lymphoma, which was of the large-cell type. In the Hodgkin's lymphoma evidence of EBV was found in the reactive lymphocytes, which are not lymphoma cells themselves, and in the Reed-Sternberg cells, which are a characteristic pathological finding of Hodgkin's lymphoma. The authors suggest that these findings indicate a possible role for Epstein-Barr virus in the pathogenesis of both lymphomas. They also indicate that their hybridization technique, which involves color development rather than the more common (but more time-consuming) radioactive-label technique, is suitable for widespread use in the investigation of the role of EBV in such malignancies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Hodgkin's disease, Identification and classification, Non-Hodgkin's lymphomas, Epstein-Barr virus, Epstein-Barr virus diseases

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Treatment of the acquired immune deficiency syndrome-related Kaposi's sarcoma with bleomycin as a single agent

Article Abstract:

Kaposi's sarcoma (KS) is a form of malignant tumor characterized by multiple areas of cell overgrowth, initially affecting the skin but later developing in other body sites. The lesions may become sarcomatous, involving connective tissue such as bone and muscle. This particular malignancy is seen in 10 to 20 percent of AIDS patients, who more often die of infections than KS. The effectiveness and toxicity of the anticancer agent bleomycin in treating non-life-threatening Kaposi's sarcoma associated with AIDS were assessed in 60 afflicted patients. These patients had widespread and progressive Kaposi's sarcoma with symptoms affecting the entire body and a CD4 count of less than 400 per cubic millimeter, an index of poor immune function. Bleomycin was given into muscle in 30 patients and by slow continuous intravenous infusion in the remaining 30 patients. The average duration of treatment was five months. Bleomycin treatment resulted in some elimination of the tumors in 29 patients; it stabilized or prevented further progression of the cancer in 18 additional patients; and it had no effect in 21.6 percent of patients. Bleomycin was discontinued in two patients because of adverse side effects. These findings suggest that bleomycin may serve as a alternative treatment for AIDS-related Kaposi's sarcoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Chemotherapy, Bleomycin

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Oral Kaposi's sarcoma in acquired immunodeficiency syndrome: review of management and report of the efficacy of intralesional vinblastine

Article Abstract:

Kaposi's sarcoma is common cancer among homosexual men with AIDS (acquired immunodeficiency syndrome); in many cases it is the first symptom of AIDS. Kaposi's sarcoma may occur in many locations, including the oral cavity. The chemotherapeutic agent vinblastine was evaluated as palliative therapy in 10 patients with oral Kaposi's sarcoma. Doses of vinblastine, ranging from 0.2 to 0.8 milligrams, were injected directly into the lesions; the precise dose was dependent upon the size of the lesion. All 10 patients had some sort of objective response to vinblastine, although a 75 to 100 percent response was observed in only 4 patients. The mean follow-up period was 3.6 months, and during that time the lesions recurred in two patients. Unfortunately, tumor progression elsewhere in the body prevented additional follow-up of four patients. Direct injection of vinblastine was found to be a palliative treatment for oral Kaposi's sarcoma with several distinct benefits. The treatment is easy and safe, and the agent is inexpensive. Furthermore, the procedure can easily be performed outside of specialized treatment centers, and may be repeated if necessary. The pain which results from the treatment is of short duration, and may be controlled by oral analgesics. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Management, Mouth cancer, Vinblastine

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