The poor insane Ophelia: reconsidering Ophelia syndrome / La pobre e insensata Ofelia: reconsiderando el síndrome de Ofelia

ABSTRACT The association between memory loss and Hodgkin's lymphoma has been given the eponym of Ophelia syndrome, in memory of Shakespeare's character in The Tragedy of Hamlet, Prince of Denmark. Nevertheless, there are differences between the disease and the character. Objective: To review the origins and uses of the eponym through an original article by pathologist Ian Carr, its relation to the character Ophelia, and the related autoantibodies. Methods: Historical narrative review. Results: Besides an eloquent description in the original article, Carr presaged the presence of autoantibodies, before they had been thoroughly researched. Since then, five different autoantibodies (mGluR5, Hu, NMDAR, SOX, PCA2) have been associated with Hodgkin's disease. It is interesting to note the divergent outcomes of Shakespeare's character and the patient in the original description by Carr, the latter recovering to lead a normal life, and the former deceased. Conclusions: Although there is little relationship between the fictional character and the syndrome, both imply the unintentional trigger of self-harm (suicide in one case, autoimmunity in the other), thus remaining associated.

RESUMO El síndrome de Ofelia describe la asociación entre pérdida de memoria y enfermedad de Hodgkin, en memoria del personaje de La Tragedia de Hamlet, Príncipe de Dinamarca, de William Shakespeare. Sin embargo, existen diferencias entre ambos. Objetivo: Revisar los orígenes y usos del epónimo a través del artículo original, su relación con el personaje y los autoanticuerpos relacionados. Métodos: Revisión narrativa histórica. Resultados: Además de una descripción elocuente, el artículo original prefigura los autoanticuerpos, cuando no se buscaban de rutina. Desde entonces, cinco distintos (mGluR5, Hu, NMDAR, SOX, PCA2) han sido asociados. Cabe destacar, que el desenlace del personaje y del paciente fueron diametralmente opuestos, el primero falleció y el segundo se recuperó, llevando una vida normal. Conclusiones: A pesar de la poca relación entre el personaje y el síndrome, ambos implican el desencadenamiento no intencional de daño auto-inflingido (suicidio en un caso, autoinmunidad en el otro), manteniendo así la adecuacía.

Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma

ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.

Validation of the Comfort scale for relatives of people in critical states of health / Validação da escala de conforto para familiares de pessoas em estado crítico de saúde / Validación de la escala de confort para familiares de personas en estado crítico de salud

AbstractObjective: this methodological study aims to present the construct validity of the Comfort scale for family members of people in a critical state of health (ECONF).Method:this is a methodological study. The sample was made up of 274 family members of adults receiving inpatient treatment in six Intensive Care Units (ICU) in the State of Bahía responded to 62 items distributed in 7 dimensions. The validation procedures adopted were based on the techniques of the Classical Test Theory.Results: the analysis of dimensionality was undertaken through principal components analysis, a scale being obtained with 55 items distributed in four factors: Safety, Support, Family member-relative interaction and Integration with oneself and the everyday. The analysis of the items' , discriminative power, undertaken by the item-total correlation-coefficient showed a good relationship of the items with their respective factors. From the ECONF's reliability test, from the analysis of internal consistency, a raised Alpha Cronbach coefficient was obtained for the 4 factors and the general measurement.Conclusion:the comfort scale presented satisfactory psychometric parameters, thus constituting the first valid instrument for evaluating the comfort of family members of people in a critical state of health. The advance made by the study lies in its theoretical framework on comfort, and provides the health team with a scale based on empirical evidence.

ResumoObjetivo:validar a Escala de Conforto para Familiares de pessoas em estado crítico de saúde.Método:trata-se de estudo metodológico. A amostra foi constituída por 274 familiares de pessoas adultas internadas em seis unidades de terapia intensiva que responderam a 62 itens, distribuídos em 7 dimensões. Os procedimentos de validação adotados foram embasados nas técnicas da Teoria Clássica dos Testes.Resultados:a análise da dimensionalidade foi realizada por meio da análise por componentes principais, obtendo-se uma escala com 55 itens distribuídos em 4 fatores: segurança, suporte, interação familiar/ente e integração consigo e com o cotidiano. A análise do poder discriminativo dos itens, realizada pelo coeficiente de correlação item-total, mostrou boa relação dos itens com seus respectivos fatores. O exame da fidedignidade da escala, por meio da análise da consistência interna, apresentou coeficiente alfa de Cronbach elevado para os 4 fatores e a medida geral.Conclusão:a Escala de Conforto apresentou parâmetros psicométricos satisfatórios, constituindo-se no primeiro instrumento válido para a avaliação do conforto de familiares de pessoas em estado crítico de saúde. A pesquisa avançou na construção de um referencial teórico sobre o conforto, e disponibilizou à equipe de saúde uma medida pautada em evidências empíricas.

ResumenObjetivo:validar la Escala de Confort para Familiares de personas en estado crítico de salud.Método:se trata de un estudio metodológico. La muestra estuvo constituida por 274 familiares de personas adultas, internadas en seis unidades de terapia intensiva, que respondieron a 62 ítems, distribuidos en 7 dimensiones. Los procedimientos de validación adoptados fueron basados en las técnicas de la Teoría Clásica de las Pruebas.Resultados:el análisis de la dimensionalidad fue realizada por medio del análisis por componentes principales, obteniéndose una escala con 55 ítems distribuidos en 4 factores: seguridad, soporte, interacción familiar/ente e integración consigo y con lo cotidiano. El análisis del poder discriminatorio de los ítems, realizado por el coeficiente de correlación ítem-total, mostró buena relación de los ítems con sus respectivos factores. El examen de confiabilidad de la escala, realizado por medio del análisis de consistencia interna, presentó un coeficiente Alfa de Cronbach elevado para los 4 factores y la medida general.Conclusión:la Escala de Confort presentó parámetros psicométricos satisfactorios, constituyéndose en el primer instrumento válido para la evaluación del confort de familiares de personas en estado crítico de salud. La investigación avanzó en la construcción de un referencial teórico sobre el confort, y suministró al equipo de salud una medida guiada en evidencias empíricas.

Morphological Typing of Lymphomas with Immunohistochemistry.

Lymphoid malignancies (LM) are a heterogeneous group of disorders that are broadly divided into Hodgkin disease (HD) and Non-Hodgkin Lymphoma (NHL). Diagnosing lymphoid malignancies based on morphology in conjunction with immunohistochemistry (IHC) forms the basis of WHO classification and this has prognostic implications.With this background this study was designed thus including all the lymphoid malignancies both NHL and HD. Materials and Methods: This study was conducted at a tertiary centre in Uttarakhand and included a total of 116 cases of lymphoid malignancies. Of these 41 cases were of Hodgkin disease and 75 cases were of NHL. These cases were initially diagnosed on morphology employing Hematoxylin and Eosin (H&E) and special stains like Reticulin. Subsequently, a preliminary panel of monoclonal antibodies using CD3, CD15, CD20, CD30, and CD45 were employed. All the cases were then classified using WHO classification. Results: HD- Of the 41 cases of Hodgkin’s disease the commonest subtype was Nodular Sclerosis seen in 26 cases (48.78%). Reed Sternberg in reactive milieu is diagnostic of Hodgkin disease. In all cases except one Reed Sternberg cells exhibited positivity for both CD15 and CD30. NHL – Of the 75 cases of NHL an initial classification based on morphology was done. All the cases were classified according to International Working Formulation initially. Subsequently, IHC was employed using CD3, CD15, CD20 and CD45. The disease was then classified according to WHO classification and broadly divided into B or T cell types. B cell expression was seen in 60 cases (80%) and T cell expression in 15 cases (20%). The commonest B cell subtype was Diffuse Large B cell Lymphoma (26.4%).

Morphologic, immunphenotypic and clinical discriminators between T-cell / histiocyte-rich large B-cell lymphoma and lymphocyte-predominant Hodgkin lymphoma

Features of T-cell/histiocyte rich large B-cell lymphoma [THRLBCL] overlap with those of lymphocyte predominant Hodgkin lymphoma [LPHL]. The two lymphomas may represent a spectrum of the same disease, and differentiation between the two can sometimes be difficult. We looked at histomorphologic, immunophenotypic and clinical information that may help differentiate the two entities. Cases of THRLBCL and LPHL were blindly reviewed and studied for histological pattern [nodular vs. diffuse], nuclear features and pattern of expression of CD20, CD30, CD57, epithelial membrane antigen [EMA] and Epstein-Barr virus [EBV]. A score encompassing diffuse histology, high nuclear grade, CD20 single-cell pattern, CD30+, CD57-, EMA-, and EBV+ was estimated for the diagnosis of TCHRLBCL. There were 58 cases, including 30 cases of TCHRLBL and 28 cases of LPHL. The median age was 36 years for TCHRLBCL and 21 years for LPHL [P=0.0001]. Three types of nuclei were identified [lymphocytic/histocytic, Reed-Sternberg and centroblast-like]. The latter two high-grade nuclei were suggestive of TCHRLBCL. TCHRLBCL and LPHL, respectively, showed diffuse histology, 90% vs. 4% [P=0.001], single CD20+ cells, 93% vs. 3.5% [P=0.00004], CD30+ cells, 30% vs. 0% [P=0.01], CD57+ cells, 41% vs. 93% [P=0.008], EMA+ cells, 27% vs. 60% [P=0.113], EBV+ cells, 24% vs. 0% [P=0.117], high nuclear grade, 70% vs. 0% [P=0.001], total score 2-7 [mean 4.68] vs. 0-2 [mean 0.72] [P=0.001], high stage, 86% vs. 7% [P=0.0001]. Our findings indicate that a combination of multiple parameters can help differentiate between the two diseases. Two cases originally diagnosed as LPHL were re-assigned the diagnosis of THRLBCL

Proliferating cell nuclear antigen (PCNA), p53 and MDM2 expression in Hodgkins disease

CONTEXT AND OBJECTIVE: Tumor cells in Hodgkins disease (HD) express cell proliferation markers that are evaluated according to the oncogenes involved or the expression of their proteins. Correlations between the protein expression grade and clinical data are now important for disease prognosis. DESIGN AND SETTING: This was a retrospective analysis on proliferating cell nuclear antigen (PCNA), p53 and MDM2 (murine double minute-2) expression using immunohistochemistry, on formalin-fixed, paraffin-embedded tissues from diagnostic biopsies on 51 patients with HD. The study was conducted at the Division of Hematology and Transfusion Medicine, Hospital São Paulo, Universidade Federal de São Paulo. METHODS: Antigen expression was evaluated as the proportions of positive Hodgkin and Reed-Sternberg (HRS) cells and reactive lymphocytes (L), which were compared using Spearman correlation coefficients. The Friedman test was used for comparisons between the markers. The Pearson test was used to investigate associations between marker expression and clinical and laboratory parameters, marrow involvement, complete remission (CR) and overall survival (OS) rates. RESULTS: There was overexpression of antigen proteins in HRS, in relation to L (p < 0.001). In HRS, MDM2 was higher than p53 and PCNA (p < 0.003), while the latter two were equivalent. In L, p53 was lower than MDM2 and PCNA (p < 0.001), while the latter two were equivalent. There was no relationship between protein expression and clinical and laboratory variables or outcome. CONCLUSIONS: PCNA, p53 and MDM2 are tumor markers for HD, but showed no clinical or prognostic significance in our analysis.

CONTEXTO E OBJETIVO: As células tumorais da doença de Hodgkin (HD) são positivas para marcadores de proliferação celular que são analisados por seus genes e respectivas proteínas. A correlação entre a expressão destas proteínas e os parâmetros clínico-laboratoriais são, no momento, de importância para o prognóstico da doença. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo da expressão do antígeno de proliferação celular (PCNA) e da p53 e MDM2 em tecidos obtidos ao diagnóstico, fixados por formol, embebidos em parafina de 51 pacientes com HD. O trabalho foi realizado na Divisão de Hematologia e Transfusão, Hospital São Paulo, Universidade Federal de São Paulo. MÉTODOS: As expressões antigênicas foram analisadas através da proporção de células de Hodgkin e células de Reed Sternberg (HRS) e linfócitos reacionais (L) positivos. A intensidade de expressão de cada proteína foi comparada entre L e HRS através do coeficiente de Spearman. A comparação da PCNA, p53 e MDM2 em L e HRS se fez pelo teste de Fiedman. As correlações entre variáveis clínico-laboratoriais, comprometimento da medula óssea, taxas de sobrevida geral e remissão clínica com as proteínas em HRS se fizeram pelo coeficiente de Pearson. RESULTADOS: Houve superexpressão das três proteínas em células HRS comparadas aos L (p < 0,001). Nas células HRS, a MDM2 foi maior que a p53 e a PCNA (p < 0,003), que foram equivalentes. Nos L, a p53 foi menor que a MDM2 e a PCNA (p < 0,001), que foram equivalentes Não houve relação entre as expressões das proteínas com as variáveis clínico-laboratoriais e sobrevida. CONCLUSÕES: PCNA, p53 e MDM2 são marcadores tumorais na HD, porém não mostraram significado clínico-prognóstico em nossa análise.

Expresión de proteínas del choque térmico HSP72 y HSP73 en casos colombianos de Linfoma de Hodgkin positivos y negativos para virus de Epstein Barr / Expression of heat shock proteins HSP72 and HSP73 in Epstein-Barr positive or negative Hodgkin lymphoma

Background: The expression of heat shock proteins (HSP70) in tumor cells or virus infected cells is important for the induction of specific cellular immune response. They are implicated in transport of immunodominants peptides in the endoplasmic reticulum, activation of antigen presenting cells and cross priming of CD8 T cells. Aim: To analyze the expression of HSP70 protein in its constitutive (HSP73) and inducible forms (HSP72) in Hodgkin's lymphoma (HL), infected or not by Epstein Barr virus (EBV) and to assess its relationship with pathological subtype, clinical stages and treatment response. Material and methods: The analysis of HSP73 and HSP72 was done by immunoperoxidase on routinely processed paraffin sections with prior antigen retrieval. Results: Sixty seven cases were studied. The expression of HSP73 and HSP72 was detected in 19.4 and 17.9% of samples respectively. The infiltrating lymphocytes expressed HSP72 in 58% of cases. The pathological subtypes with the higher expression in lymphocytes were mixed cellularity and nodular sclerosis. No differences in HSP70 expression were observed, according to clinical stage, treatment response or the presence of EBV. Conclusions: The expression of HSP72 on lymphocytes suggests that this protein plays an important role in the induction and amplification of anti-tumor immune response (Rev Méd Chile 2003; 131: 1375-81).

Retinitis por citomegalovirus en pacientes inmunosuprimidos, VIH negativos: reporte de dos casos / Cytomegalovirus retinitis in negative HIV immunocompromised subjects: two cases report

La retinitis por citomegalovirus es una complicación frecuente y seria en enfermedades caracterizadas por cursar con inmunosupresión. En este articulo, los autores presentan los hallazgos clínicos de la retinitis por citomegalovirus en 2 pacientes inmunocomprometidos. El primero con enfermedad de Hodgkin, y el segundo con un transplante renal, ambos VIH negativos.

Apoptosis y proliferación celular en infecciones por el virus Herpes humano 6 (HHV-6). Mecanismos de regulación a través de interacciones de p53, bcl-2, ras y p21WAF / Apoptosis and celular proliferation in human herpes virus 6 (HHV-6) infection. Mechanism as of regulation by interactions of p53, bcl2, ras and p21WAF

Se analizaron inmunohistológicamente líneas de cultivo celular infectadas con el HHV-6: HSB2-células T inmaduras y HDLM2-células de Hodgkin, así como ganglios linfáticos de pacientes con enfermedad de Hodgkin y linfadenitis de Kikuchi-Fujimoto (LKF) en relación a la expresión de los productos oncógenos/antioncógenos p53, bcl-2, ras y p21WAF. Se comprobó la proliferación celular inmunohistológicamente mediante anticuerpos contra PCNa (antígeno nuclear de proliferación celular) y la apoptosis se investigó en cortes finos de tejido ganglionar, analizando el ADN fragmentado con marcación final in situ. La LKF mostró alta incidencia de focos de células muertas (linfadenitis histiocítica necrozante), mientras que en la enfermedad de Hodgkin se observó proliferación celular. Con las técnicas utilizadas no se logró mostrar diferencias significativas en la expresión de ADN viral no de antígenos en las líneas celulares, ni en las biopsias de enfermedad de Hodgkin y de LKF. Las células HDLM2 con mejor viabilidad posterior a la infección con HHV-6 y un grado de apoptosis inferior, mostraron una expresión de p53 y de PCNA mucho menor que las células HSB2. Las biopsias de LKF no expresaron p53; ras se observó en menores células que en la enfermedad de Hodgkin y la positividad de PCNA fue tres veces mayor en enfermedad de Hodgkin en comparación con LKf. Sin embargo el bcl-2 se observó con mayor frecuencia en LKF que en enfermedad de Hodgkin. Los resultados no son de fácil interpretación; los datos sugieren la implicación de otros factores exógenos (por ejemplo, citoquinas y factores de crecimiento) en el mecanismo regulatorio de la proliferación celular y de la apoptosis, ambas inducidas probablemente por virus

Disminucion de los linfocitos CD3+ de sangre periferica en pacientes con linfomas / Decrase of CD3+ lymphocytes in the peripheral blood of lymphoma patients

Los anticuerpos monoclonales anti-celula T fueron probados por inmunoflorescencia sobre celulas mononucleares perifericas obtenidas de 99 pacientes con linfomas no Hodgkin (LNH), 84 con enfermedad de Hodgkin (EH) y 16 adultos sanos. El objetivo de este estudio es describir la expresion de antigenos de diferenciacion leucocitarios humanos CD3, CD4 y CD8 en los linfocitos circulantes de pacientes sin tratamiento previo. Las comparaciones de patrones de reactividad entre los pacientes y los adultos sanos permitio observar que las medias de los valores porcentuales de celulas CD3+ fueron estadisticamente diferentes (p<0,001), a expensas de una alta frecuencia de individuos con conteos bajos CD3+ en ambas entidades, asi como frecuentes alteraciones de las subpoblaciones CD4+ y CD8+, aunque con diferencias estadisticamente no significativas en cada grupo de pacientes en relacion con el control sano. El fenotipo CD3+, CD4+ CD8+ no logro discriminar las muestras de pacientes con EH de los LNH, como era lo esperado, dada la heterogeneidad de ambos procesos

Impairment in cellular protein phosphorylation by mitogen activated lymphocytes from patients with Hodgkin's disease.

T cell activation process in patients of Hodgkin's disease was studied in terms of cellular protein phosphorylation following interaction of T lymphocytes with mitogen PHA. Peripheral blood lymphocytes from Hodgkin's disease patients and healthy donors, labelled with [32P] were activated with PHA. The cell lysates were subjected to SDS-PAGE, 2-dimensional gel analysis and were autoradiographed. It was observed that lymphocytes from both Hodgkin's disease patients and healthy donors followed similar time kinetics of phosphorylation. Nine of the eleven major protein bands, resolved on SDS-PAGE in the molecular weight range of 15.7-98 kD showed reduced phosphorylation (ratios of densitometric readings taken after and before stimulation) compared to that of healthy donors. Isoelectric focusing of these major protein bands in 2-dimensional gels further resolved them into about 27 proteins. Most of these showed increased phosphorylation in lysates of activated lymphocytes from healthy donors compared to that of Hodgkin's disease patients. The results showed a defect even at an early stage in terms of inadequate cellular protein phosphorylation.

Lymphocytotoxic activity in untreated Hodgkin's disease

This work included 45 patients with untreated Hodgkin's disease. Sera from 14 patients [31%] contained lymphocytotoxic serum factors [LT] as judged from at least 50% lysis of lymphocytes of 23 randomly selected normal individuals. Lymphocytotoxic sera were more frequently encountered in patients with B symptoms, advanced disease, or mixed cellularity/lymphocyte depletion histopathologic characteristics. LT were often found in patients with large and tumor-involved spleens. The ability of patient's serum to inhibit control lymphocyte response to concanavalin stimulation was significantly higher in the group of LT-positive patients as compared to LT-negative patients. In conclusion, the presence of LT in patients with untreated Hodgkin's disease may play a role in the immunodeficiency of the disease, and could be used as a parameter for the prognosis of the disease

Lymphoma associated antigen (LAA)--a unique biomarker for lymphomas.

A lymphoma associated antigen (LAA) isolated from pooled lymph nodes of confirmed Hodgkin's and non-Hodgkin's lymphomas has been purified and characterized. Using a xenogenic rabbit anti-serum, enzyme-linked immunosorbent assay (ELISA) and RIA were developed for LAA. LAA was detected in the sera of all confirmed lymphomas, the test being negative for normals, for patients with benign lymphadenitis and various other types of cancers. Except for a very few false positive results, no false negative was observed. LAA was identified in urine, CSF, saliva and gastric juice of a few lymphoma patients, and the test proved to be of diagnostic potential, as for a few patients it had a lead time of a few months over the histological diagnosis. In order to render the LAA test more precise and specific, monoclonal antibodies were generated by both in vitro and in vivo immunization procedures. Seven monoclonals were generated, viz. 7D6, 7D2, 7G2, 7C5, 6G2, 23B7 and 23G11, which exhibited cytoplasmic staining of frozen sections of malignant lymphoid tissues of B cell derived non-Hodgkin's lymphomas. Two of these monoclonal antibodies, 7D6 and 23B7, revealed strong cytoplasmic staining of frozen sections, impression smears and cytospin specimens of B cell non-Hodgkin's lymphomas. The reactivity was very weak or negative for T cell lymphomas. The test was negative for Hodgkin's disease and controls. These results were confirmed by dot blotting, immunoprecipitation and immunofluorescence study. By ELISA with a sensitivity of 15 ng/ml, serum LAA levels for lymphomas were in the range 72-1250 ng/ml. LAA could not be detected in the sera of normals and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Fenotipo inmune del linfoma de Hodgkin en la infancia / Immune phenotype of childhood Hodgkin's lymphoma

Se estudiaron 10 casos de linfoma de Hodgkin (LH) en niños (4-14 años), subtipos predominio linfocítico-histocítico (PLH):2, escleronodular (EN)Ñ 4, celularidad mixta (CM): 3 y depleción linfocítica (DL): 1, con un panel de inmunosueros monoclonales constituído por: Ki1 (CD30, BerH2), M1 (Leu M1, Tü9, VIM D5), UCHL1 (marcador de linfocitos T) y 4KB5 (marcador de linfocitos B) sobre cortes de material fijado en Bouin alcohólico e incluído en parafina. La inmunomarcación con Ki1 fue positiva en las células de Reed-Sternberg (R-S) y de Hodgkin (H) en los subtipos EN, CM y DL. No hubo reactividad en el PL-H nodular. El M1 marcó las células de R-S y H en CM y EN, resultando negativo en el PL-H y DL. El UCHL1 y el 4KB5 tiñeron la población linfocítica reactiva de las líneas T y B respectivamente. Estos hallazgos permitieron comprobar el patrón de reactividad de los anticuerpos monoclonales Kil y M1 en estudios retrospectivos de tejido ganglionar con LH, datos que pueden resultar de utilidad en el diagnóstico diferencial con otros linfomas (L no H de células grandes e histiocíticos verdaderos).

Serum immunoglobulins in leukaemia and malignant lymphoma.

The serum immunoglobulin levels were studied in 25 healthy control subjects and 23 cases of leukaemia (6 cases of acute lymphatic leukaemia, 5 cases of acute myeloid leukaemia, 2 cases of chronic lymphatic leukaemia and 10 cases of chronic myeloid leukaemia) and 17 cases of malignant lymphoma (13 cases of Hodgkin's lymphoma and 4 cases of non-Hodgkin lymphoma). The mean levels of IgG, IgA and IgM in 25 control subjects were 1573.56 +/- 91.45 mg/dl, 209.64 +/- 12.55 mg/dl and 109.81 +/- 10.03 mg/dl respectively, those in 23 cases of leukaemia were 1338.23 +/- 109.74 mg/dl, 195.53 +/- 20.72 mg/dl and 127.47 +/- 13.29 mg/dl respectively and those in 17 cases of malignant lymphoma were 996.99 +/- 99.50 mg/dl, 147.47 +/- 19.61 mg/dl and 129.35 +/- 19.95 mg/dl respectively. The mean levels of IgG and IgA were found to be decreased in cases of leukaemia with elevated levels of IgM, however, it was found to be insignificant (p less than 0.4). The mean IgG, IgA and IgM levels were found to be almost identical in different leukaemia irrespective of cytological types except in 2 cases of chronic lymphatic leukaemia which showed low levels of IgG and IgA. The mean levels of IgG and IgA were found to be significantly decreased in malignant lymphoma (p less than 0.02). IgM levels were found to be increased in 3 cases of non-Hodgkin lymphoma.

Doença de Hodgkin: revisäo; Parte IV. Imunologia / Hodgkin's disease. Review. Part 4 - Immunology

Pacientes com doença de Hodgkin näo tratados, mesmo em estádios localizados, exibem um defeito imunológico caracterizado por uma acentuada reduçäo da imunidade celular, enquanto que imunidade humoral pemanece inalterada. Estes pacientes apresentam uma elevada susceptibilidade as infecçöes com germes oportunistas e a tuberculose. As alteraçöes imunológicas associadas a imunossupressäo induzida pelo tratamento persistem mesmo nos pacientes em remissäo contínua completa de longa duraçäo. O mecanismo que leva a uma resposta imunológica alterada parece ser complexo e sua patogênese é desconhecida

Role of immunoglobulin estimation in lymphomas.

50 cases of biopsy proved primary nodal lymphomas were selected and serum immunoglobulins IgA, IgG and IgM were estimated by SRID method. Clinical stage and histological sub-typing were correlated with Immunoglobulin levels.

Algunas consideraciones sobre la inmunidad en los linfomas / Immunity in lymphomas

En el presente estudio se analizan aspectos inmunológicos de posible valor pronóstico en nueve pacientes con enfermedad de Hodgkin y en ocho con linfomas no Hodgkin. La depresión de la hipersensibilidad retardada cutánea medida con antígenos de memoria apareció con mayor frecuencia en enfermos con linfomas no Hodgkin, mientras que evaluada la sensibilización con un antígeno primario (DNCB), fue mayor en la enfermedad de Hodgkin. La disfunción de la inmunidad celular se acompañó de una disminución relativa en los conteos de linfocitos T, más acentuada en pacientes portadores de enfermedad de Hodgkin, en los cuales se observó conjuntamente, un descenso de la relación T4+/T8+