Cancer mortality among patients with Hansen's disease

Six cases of leprosy associated with allogeneic hematopoietic SCT

We report here the first six cases of leprosy associated with HLA-identical allogeneic SCT in different phases and with different findings and outcomes. Skin and peripheral nerves may be sites of leprosy associated with SCT, stressing the importance of differential diagnosis between leprosy and GVHD or drug reactions. Clinical manifestations of leprosy before or after transplantation did not influence the outcome of SCT in our cases.

Quantitative prediction of human cancer risk from rodent carcinogenic potencies: a closer look at the epidemiological evidence for some chemicals not definitively carcinogenic in humans

The existence of rodent carcinogens for which at least one epidemiological study found no evidence of human carcinogenicity has been claimed to provide evidence of the poor predictivity of rodent bioassays (F. K. Ennever, T. J. Noonan, and H. S. Rosenkranz (1987). Mutagenesis 2, 73-78). We have performed quantitative comparisons of the rodent and human carcinogenic potencies for these same chemicals. Starting with the rodent TD50 at the most sensitive site, we derived a predicted human incidence for the degree of exposure and duration of follow-up corresponding to the most comprehensive epidemiological study available, and then we compared the predicted incidence with the observed incidence. If a chemical produced no statistically significant increase in cancer at any site in the exposed population, consistency with rodent results is inferred if the minimum rodent TD50 is sufficiently high that no attributable cases would have been expected under the actual conditions of human exposure and follow-up. For 18 of the 22 chemicals examined, the human evidence is consistent with the predictions based on the rodent bioassay results. For two chemicals, dichlorobenzidine and ethylene thiourea, there is not enough epidemiological information to make a useful comparison with rodent bioassay data. For the two remaining chemicals, actinomycin D and vinylidene chloride, the human evidence is inconsistent with the predictions. But the conditions of the rodent bioassay of actinomycin D were inappropriate for the comparison, and for vinylidene chloride the human exposure dose and duration were uncertain; either chemical might yet demonstrate consistency with the rodent results in future epidemiological studies.

Differential sensitivity of peripheral blood lymphocytes of untreated leprosy patients to mitomycin C

The effects of a bifunctional alkylating agent mitomycin C (MMC), an effective inducer of chromosome aberrations and sister-chromatid exchanges (SCEs), have been studied in untreated leprosy patients. This was done to study the mutagen sensitivity of the leprosy patients. The frequency of chromosomal aberrations induced by MMC (conc. 0.01 microgram/ml) was 2.5% in controls, 3.6% in paucibacillary (PB), and 6.8% in multibacillary (MB) patients. The difference in the frequency of MMC-induced chromosome aberrations between the 3 groups studied was highly significant (p less than 0.01). Cultures grown with MMC showed the frequency of SCEs/cell to be 12.70 +/- 1.19 in controls, 19.97 +/- 3.51 in PB, and 29.66 +/- 5.92 in MB patients. The differences in the frequency of MMC-induced SCEs between the 3 groups were found to be highly significant (p less than 0.01). The enhanced frequencies of spontaneous and MMC-induced chromosome aberrations and SCEs observed in PB and MB patients indicate a clear differential mutagen sensitivity between PB and MB patients who are known to have different immunological status and thereby differ in the severity of the disease.

Hansen's disease following lymphoma

We report two instances of Hansen's disease as a complication of lymphoma. Although patients with leprosy may be at risk for the development of neoplasia, the converse has only rarely been reported. Nonetheless, granulomatous lesions in patients with lymphoreticular malignancy should suggest appropriate studies to rule out Hansen's disease, as illustrated by the cases detailed herein.