Serum immunoglobulins to endotoxin core glycolipid: acute leukaemia and other cancers

Article Abstract:

The prognosis of children treated for cancer is affected adversely by infectious illnesses. Infections with gram-negative bacteria can be particularly critical. Humans can produce protective antibodies which recognize a portion of these bacteria, known as endotoxin core glycolipid. High levels of antibodies against endotoxin core glycolipid have been associated with enhanced survival from some gram-negative infections. The levels of naturally occurring protective antibodies in children with leukemia and other cancers were evaluated to determine if preventive treatment with antibodies against endotoxin might be appropriate for these patients. In children with one type of leukemia (acute myeloid) and in those with solid tumors, levels of antibodies against core glycolipid were lower than in healthy children, while total levels of antibodies were the same or greater. However, the decreased antibody type was of a subclass that is not very important in fighting bacterial infections. Children with a second type of leukemia (acute lymphoblastic) had lower levels of antibodies during chemotherapy treatment. Both total antibody levels and antibodies that are specific against endotoxin core glycolipid were decreased. In these same children, the number of episodes of fever during treatment significantly correlated with decreased levels of antibodies against core glycolipid. Correlations to total antibody levels are not reported; consequently, the specificity of the fever-antibody correlation is unclear. The study suggests that children with leukemia may benefit from treatment with antibodies which are specific for bacterial endotoxin core glycolipid. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Gram-negative bacteria, Cancer in children, Childhood cancer, Endotoxins, Gram negative bacterial infections

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Influenza A and the virus associated haemophagocytic syndrome: cluster of three cases in children with acute leukaemia

Article Abstract:

Virus-associated hemophagocytosis syndrome (VAHS) is a condition in which red blood cells in the bone marrow are destroyed by cells whose job it is to ingest foreign material, called phagocytes, in the presence of a viral infection. Herpes viruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are common causes of VAHS, and herpes simplex, zoster, adenovirus and the human immunodeficiency viruses also have been implicated. Such proliferation of bone marrow phagocytes, or histiocytes (a phagocytic cell type found in connective tissue), has also been seen in some cases of leukemia or lymphoma (malignancies of white blood cells) when no infection is present. Histiocytosis in these cases is usually fatal. It is possible that this disorder is actually a form of initially non-life-threatening VAHS in which chemotherapy-induced suppression of the immune system leads to the poor prognosis. The case reports are presented of three children with leukemia undergoing chemotherapy who developed extensive bone marrow histiocytosis and hemophagocytosis with physiological changes similar to those seen in VAHS. The patients, two of whom died, were concomitantly infected with the influenza A virus. Diagnostic concerns regarding VAHS are discussed; distinguishing between this disorder and life-threatening histiocytosis can be difficult. The characteristic features of VAHS are described. These case studies indicate that influenza A virus should be considered a cause of VAHS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Pediatric diseases, Virus diseases, Influenza viruses, Blood diseases, Hematologic diseases, Virus diseases in children

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Cryptosporidiosis and acute leukaemia

Article Abstract:

Cryptosporidiosis is a parasitic infection by the protozoa Cryptosporidium. This protozoa is known to cause disease in animals, and has recently been cited as a major cause of diarrhea in humans. Infection in otherwise healthy patients can be self-limiting. However, the parasite can cause severe disease and death in patients with a compromised immune system caused either by disease or induced by cancer chemotherapy. The experience of six immunosuppressed children infected with cryptosporidium is reported. The children were receiving chemotherapy to treat leukemia (five children) or lymphoma (one child). Two children had their chemotherapeutic regimen altered, which improved symptoms of the parasitic infection. Two other children stopped methotrexate, a chemotherapeutic agent with many gastrointestinal side effects. Methotrexate is known to affect the lining of the intestines by damaging and predisposing the gut to the parasitic infection. A change in chemotherapy was helpful in eradicating the parasite, which enabled the four children to continue cancer treatment. The two children who died had evidence of a persistent parasitic infection. It is unclear how the children contracted the parasite. In one case, a hospital-acquired infection was suspected. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Intestines, Coccidia, Cryptosporidium

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