Measles and rubella vaccine antibody levels in children with acute lymphoblastic leukemia following chemotherapy

Children in remission from acute lymphoblastic leukemia [ALL] have a high prevalence of immune system defects; one of them is the decrease of vaccine-induced antibody seropositivity rates. This antibody deficiency may place children with ALL at risk for the development of vaccine- preventable diseases, even after completion of chemotherapy, and they could function as a reservoir for additional spread of these diseases in the population. The aim of the present study was the assessment of the levels of vaccine- induced antibodies against measles and rubella viruses n ALL children following chemotherapy. Antibody levels against measles and rubella vaccine viruses were evaluated by ELISA technique in 96 children with ALL after completion of chemotherapy, in addition to 30 healthy children [non cancer controls of matched age and sex]. All healthy children were seropositive for measles and rubella antibodies. On the other hand, out of 96 children who received chemotherapy, only 19 [19.8%] were seropositive for measles antibodies, while 70 [72.9%] were seropositive for rubella antibodies. Most of measles seropositive cases [57.9%] had low levels of measles antibodies while among control group most children [56.7%] had high levels of measles antibodies, Similarly among children who received chemotherapy, most of the seropositive cases [45.7%] had low levels of rubella antibodies, while among control group, most of children [36.6%] had high levels of rubella antibodies. Seropositivity rate of measles was found to be related to the age at diagnosis and disease duration, while that of rubella was found to be related to the disease duration only. Most of children who have been treated with chemotherapy for ALL had lost measles antibodies and to less extent rubella antibodies. Among seropositive cases, levels of measles and rubella antibodies are low following treatment with chemotherapy compared to levels among normal controls. Therefore, revaccination of children with ALL following completion of chemotherapeutic treatment against measles and rubella is recommended

Intraoperative esophagoscopyL a diagnostic modality

A new modality, intraoperative esophagoscopy [IOE], was evaluated and compared to other diagnostic tools for the assessment of the lower margin of hypophayngeal carcinoma and the esophagus distal to the lesion. This study was carried on 25 patients with hypophayngeal carcinoma obstructing the pharyngoesophageal junction on endoscopy. Assessment of the lower tumor margin and esophageal mucosa was done by barium swallow, CT scan, intraoperative esophagoscopy [IOE] and serial sectioning of the specimen after resection. It was found that barium swallow is more accurate than CT in deciding the level of the lower extent of the tumor, but both measures failed to give any data about the extent of submucosal spread, the presence of skipped lesions and/or second primary. On the other hand, sensitivity of IOE to detect mucosal and .submucosal tumor extension inferior to the macroscopic tumor margin was 95%and 80% respectively. By this method, the upper obstructing lesion was bypassed, and also the use of different angled telescopes allowed a better and magnified view of the mucosa below the macroscopic lower tumor margin. The use of Toluidine blue 1% permitted detection of mucosal spread, which augmented the value of IOE

Long term survival in breast carcinoma

One hundred and six previously treated patients, with breast carcinoma were studied from 1136 breast carcinoma cases attended the clinical oncology and nuclear medicine department, Mansoura university in the period from January 1991 till December 1995 inclusive. These 106 cases were followed up till december 2000. The aim of the study is to evaluate the results of different treatment modalities and assessment of different prognostic factors on recurrence rate [R.R] and recurrence free survival rate [R.F.S]. In both stages II and III, R.R was less and R.F.S was mere in the group received adjuvant chemotherapy or tamoxifen in comparison to the group did not receive adjuvant systemic treatment. Recurrence rate was less and recurrence free survival was more in the group with negative lymph nodes compared to the group with positive lymph nodes. The same results was found in evaluation the value of tamoxifen. Recurrence rate was found less in patients with grade I tumour in comparison with group with grade II or III. Also R.R. was less and R.F.S was more in cases with less number of positive lymph nodes