Effect of local radiotherapy on the antibody levels against EBV-induced early and capsid antigens (EA and VCA) in patients with certain malignant tumours

The effects of radiotherapy on the immune system of patients with nasopharyngeal carcinoma

We report on 123 patients with nasopharyngeal carcinoma whose immune status was measured at the time of diagnosis, the day radiotherapy was completed, and then 2-3 months and 6-8 months after completion of radiotherapy. Immunological tests performed included the lymphocyte transformation test, the erythrocyte-rosette formation test (ERFT), the 29 degrees C erythrocyte-rosette formation test (29 degrees C ERFT), lymphocyte counts (lymphocytes/mm3 and percentage of lymphocytes), levels of serum immunoglobulins (IgG, IgA, IgM), complement (C3) and circulating immune complexes (CIC), the antinuclear antibody test and a skin test using phytohaemagglutinin (PHA). There were statistically significant differences in all tests (except C3) between patients and normal controls. Marked differences were seen in the lymphocyte count, ERFT, and 29 degrees C ERFT after radiotherapy (p less than 0.01). The diameters of induration of the PHA skin tests were less than those before radiotherapy (p less than 0.01). There were higher incidences of recurrence and metastases in the patients with high levels of CIC and low numbers of lymphocytes in the peripheral blood after radiotherapy. Cellular immunity remained at a low level 8 months after radiotherapy.

Preoperative radiotherapy in operable breast cancer: results in the Stockholm Breast Cancer Trial

A randomized trial of preoperative radiotherapy in operable breast cancer was conducted from 1971 to 1976. The diagnosis was established by fine-needle aspiration biopsy. A dose of 4500 rad over five weeks was given to the chest wall, the breast and the lymph nodes of the axilla, the supraclavicular fossa and the internal mammary chain. Modified radical mastectomy was performed six weeks or more after completed radiotherapy. In control patients the same operation was performed without prior radiotherapy. By random allocation, one control group received no further treatment and postoperative irradiation was given to the other controls. Preoperative radiotherapy reduced the incidence of local and regional recurrence and of distant metastases, and also the mortality, as compared with the surgery only group. Postoperative radiotherapy as given in this trial gave almost equal reduction of local and regional recurrence but did not diminish the frequency of distant metastases or the mortality.

A case control study on immunity to two Epstein-Barr virus-associated antigens, and to herpes simplex virus and adenovirus in a population-based group of patients with Hodgkin's disease in Denmark, 1971-73

One hundred and eighty-five patients with untreated Hodgkin's disease (HD) comprising 86% of all new cases diagnosed in Denmark over a 2-year period, were individually matched with healthy controls of the same age, sex, and social class. In comparison to controls, HD patients showed significantly elevated mean antibody titres to Epstein-Barr viral capsid antierences in mean titres were found for adenovirus common antigen. Subdivision of the patients by age, sex, social class, HL-A antigens, stage of disease and histology did not alter this pattern, except that significant case-control differences in EB-VCA titres could be demonstrated only for the nodular sclerosis and lymphocyte predominance subgroups. After 1 year of treatment, a significant rise in EB-VCA mean titre had taken place. Splenectomy seemed to promote this titre elevation. Neither the initial titres to EB-VCA and EBV-EA nor changes in titres over time were related to prognosis. The results of our study, which are more representative of a population of HD patients and controls than previously reported studies, confirm that the reported relationship between EBV and HD exists, but that the elevated EBV titres are probably not of etiologic significance in most HD patients.

Burkitt's lymphoma - a human tumor model system for immunological studies

Burkitt's lymphoma occurs mainly in parts of tropical Africa and has attracted the attention of experimental workers due to its epidemiological and clinical features, which indicate a viral etiology and a host immune response to the tumor. As a result of virological studies, Epstein-Barr virus (EBV) DNA has been demonstrated in almost all tested biopsies of African BL. This contrasts to the absence of EBV in all, or almost all, of the non-African Burkitt's lymphoma-like tumors, even though the number of tested tumors in this group is small, and to the lack of EBV in all other types of lymphoma or leukemia. Immunological studies have revealed the presence of antibodies to different EBV-associated antigens in all African patients with Burkitt's lymphoma. However the antibodies are not specific for Burkitt's lymphoma but are found in most adults all over the world, although at lower levels. They cannot therefore serve diagnostic purposes, but they can give prognostic information and occasionally give clues to the mechanisms behind late tumor recurrences, and possibly guide so-called immunotherapy. Burkitt's lymphoma patients contrast to appropriate control groups where some of the persons are anti-EBV seronegative, and this, together with the presence of EBV in Burkitt's lymphoma biopsies and the absence of EBV in other lymphomas, even though the cell type involved may be infectable by EBV in vitro and the tumor may arise in an EBV-carrying person, favors an etiological role in EBV in Burkitt's lymphoma and speaks against the "passenger" hypothesis, according to which EBV is picked up by the Burkitt's lymphoma cell which happens to be particularly suitable for EBV persistence. To explain the geographical distribution, a cofactor, such as certain forms of malaria, has been implied.

Epstein-Barr virus-associated membrane-reactive antibodies during long term survival Burkitt's lymphoma

Antibodies to Epstein-Barr virus associated cell membrane antigens persisted or slowly decreased during prolonged uncomplicated survival of patients with Burkitt's lymphoma in remission. Serum was sampled from four patients within 6 months before recurrence occurring after the first year and preceded by remission during more than 6 months. Rapid and significant decreases of the antibodies before clinical recognition of the recurrences were found in three patients. The fourth patient had slowly increasing titers before relapse. Immune stimulant treatment during remission, with BCG (Bacille Calmette Guérin vaccine) or BCG + Bordetella pertussis, temporarily increased the antibody levels. Possible mechanisms for the observed titer changes before recurrence are discussed.

Anti-Epstein Barr virus antibody in nasopharyngeal carcinoma

A retrospective study of anti-Epstein Barr virus (anti-EBV titers) in the sera of 400 patients with nasopharyngeal carcinoma (NPC) in Taiwan according to the clinical staging system of American Joint Committee is reported. Of NPC patients, 60% were seropositive (> 1:1640), while such values occurred only in 17.7, 10.9 and 20.6% respectively of normal adults, inflammatory diseases of the nose and throat, and head and neck tumor patients other than NPC (control groups). The geometric mean titer was 1:404 in NPC patients, and 1:116, 1:80 and 1:125 respectively in the three control groups. When 321 patients were staged, the seropositive rate increased successively from 12.5% in Stage I to 77.2% in Stage IV. Statistically, Stage I NPC patients had the same titer as the three control groups and a highly significant difference in chi-square tests from those in other stages. Radiotherapy did not influence the anti-EBV titers much; however, there was a definite decrease of titers in patients 7–18 months postradiotherapy. Thirty patients with recurrent disease and 28 patients with distant metastases demonstrated high positive titers and high geometric mean titers falling between those in Stage III and Stage IV. The correlation between EBV and NPC is discussed.