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

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