Concurrent infectious mononucleosisand acute leukemia. Case reports. Review of theliterature and serologic studies with the herpes-type virus (EB virus)

Reduced risk of recurrent leukaemia in bone marrow transplant recipients after cytomegalovirus infection

The first 72 consecutive bone-marrow transplant recipients with haematological malignancies (29 with acute nonlymphoblastic leukaemia, 31 with acute lymphoblastic leukaemia, nine with CML and three with myelofibrosis, IgA myeloma and T-cell lymphoma, respectively) were investigated for the frequency of relapses 1 year or later after bone-marrow transplantation. Seven relapses occurred from 30 to 850 d after transplantation (median 180 d). All relapses occurred in patients with acute leukaemia less than or equal to 18 years of age with a high risk for relapse, i.e. transplanted in second or later remission or with more than 10% blasts in the marrow before transplantation. Among all patients the probability of relapse was increased in patients without cytomegalovirus (CMV) infection (P = 0.001) and in patients without chronic GVHD (P = 0.049). Among leukaemic patients less than or equal to 18 years of age with a high risk of relapse all relapses occurred in patients (n = 11) without CMV infection, whereas no relapses were seen in patients (n = 13) with CMV infection (P = 0.006). Known risk factors for leukaemic relapse were comparable in both groups.

Quantitative light and electron microscopic changes in thymic reticular epithelial cells during Moloney-virus-induced lymphoma development

This report describes two types of reticular epithelial cell in the thymic cortex of the BALB/c mouse, an immature and a mature form. During early stages of lymphoma development, i.e., 2-6 weeks postinfection (p.i.) with Moloney leukemia virus (M-MuLV), activation of the epithelial cells is observed. Although the percentage of these cells in the total cell population of the thymic cortex remains constant during that time, the number of mature epithelial cells is significantly increased in infected animals. Subsequently, about 6 weeks p.i., the number of immature epithelial cells starts to increase, whereas the number of mature reticular epithelial cells declines and the appearance of the mature epithelial cells changes drastically. The results of light and electron microscopic studies indicate degeneration of the mature reticular epithelial cells at the onset of lymphoma development at a time when the first deficiencies in the immunologic competence of the reticular epithelial cells are apparent.

Fatal lymphoproliferation and acute monocytic leukemia-like disease following infectious mononucleosis in the elderly

Three elderly patients are reported, in whom serologically confirmed recent infectious mononucleosis is followed by fatal lymphoproliferation (case 1), by acute monocytic leukemia (case 2), and by acute probably monocytic leukemia (case 3).

Infections in leukemic children: a prospective analysis

A 28-month prospective study of 54 leukemic children was carried out to determine the incidence and type of infection associated with febrile episodes. Fever was caused by infections in 84 of 199 episodes (71%). Two-thirds of the febrile episodes and 57% of the documented infections occurred when leukemic activity was demonstrable. However, only nine of 29 febrile episodes which occurred at the time of initial diagnosis of acute leukemia were due to infection. All serious bacterial infections occurred in children with absolute granulocyte counts less than 500/mm3. Septicemia was responsible for seven of the 17 deaths which occurred during the period of observation. The five children with Pseudomonas infections were colonized 10 to 30 days before they developed their infection. The majority of viral infections occurred in patients in remission, and were principally caused by cytomegalovirus, varicella-zoster virus, or Epstein-Barr virus. With the exception of one patient who died with a complex infection (CMV and Pneumocystis carinii), the children in this study responded well to viral infections.

EB-virus-specific IgM and IgG antibodies in first-degree relatives of children with acute lymphoblastic leukaemia

EB-virus-specific IgM and IgG antibodies (to virus capsid and soluble complement fixing antigens) were estimated in sera from mothers and sibs of children with acute lymphoblastic leukaemia, from patients with infectious mononucleosis, and from control induviduals. IgM antibodies were present in 12 of 16 mothers and 3 of 4 sibs of children with acute lymphoblastic leukaemia. They were also present in 14 of 16 patients with infectious mononucleosis, but in only 1 of 12 control individuals.

Antibodies to Epstein-Barr and other viruses in children with acute lymphoblastic leukaemia

Sixty-eight children with acute lymphoblastic leukaemia were tested for antibodies to Epstein-Barr (EB) virus and to other viruses. The antibody response to the test viruses in these children was unremarkable, with the exception of EB virus, where the presence of complement-fixing antibodies in children tested during the first month of their illness suggested that a higher proportion had previous experience with this virus than was the case in control children. The implications of this observation with regard to leukaemogenesis are discussed.