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M9471071.TXT
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Document 1071
DOCN M9471071
TI An epidemiological approach to the etiology of Hodgkin's disease.
DT 9409
AU Merk KF; Karolinska Institutet, Sweden
SO Diss Abstr Int [C]; 54(2):506 1993. Unique Identifier : AIDSLINE
ICDB/94696103
AB In focus of this thesis were factors of potential importance for the
development and outcome of Hodgkin's disease (HD), especially the cause
of the immunodeficiency (ID) and its relation to HD. The epidemiological
features of HD in Cuba and Sweden were studied. A bimodal age-specific
incidence pattern was seen in Sweden while in Cuba a shift from an
unimodal to a bimodal pattern was recorded. This change was paralleled
by the Cuban development from an agricultural to a more industrialized
country. The data support the hypothesis of an intermediate incidence
pattern in HD preceding that seen in highly developed countries. In
order to test the hypothesis of a causal relationship between blood
donation and development of HD and other tumors, the incidence of cancer
among 37,795 blood donors was studied. The total number of malignancies
was lower than that expected. No increased risk of HD was found. Blood
donors may lead a more healthy life than the rest of the population
explaining at least in part their lower cancer incidence. Lymphocyte
functions and T cell counts and subpopulations were related to clinical
characteristics and prognosis in 262 HD patients. Patients with an
increased spontaneous and decreased Concanavalin A induced blood
lymphocyte DNA synthesis had a poor prognosis. In multivariate analysis
lymphocyte function was the strongest prognostic factor besides age. To
study the possible existence of genetic/environmental factors
contributing to the ID associated with HD consanguineous and
non-consanguineous relatives to consecutive patients with HD were
studied. Blood lymphocyte abnormalities were found in 32% consanguineous
and 17% non-consanguineous healthy relatives as compared to 16% healthy
controls supporting the concept of genetic factors contributing to the
ID in HD. Epstein-Barr virus (EBV) serology was studied in untreated HD
patients and related to clinical characteristics. An elevated antibody
titer to virus capsid antigen (VCA [IgG]) was observed. Patients with
advanced and relapsing disease had higher titers to VCA (IgG) and EBNA
as compared to patients with limited disease and those who remained in
complete remission. EBV serology during the course of disease revealed
continuously elevated anti-VCA (IgG) titers. (Not available from
University Microfilms Int'l.)
DE Antibodies, Viral/ANALYSIS Antigens, Viral/ANALYSIS Blood Donors
Cuba/EPIDEMIOLOGY DNA, Neoplasm/BIOSYNTHESIS DNA-Binding
Proteins/ANALYSIS Herpesvirus 4, Human/IMMUNOLOGY Hodgkin's
Disease/EPIDEMIOLOGY/*ETIOLOGY/GENETICS/IMMUNOLOGY Human Leukocyte
Count Sweden/EPIDEMIOLOGY T-Lymphocytes/IMMUNOLOGY/PATHOLOGY THESIS
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).