The promise of a prophylactic Epstein-Barr virus vaccine.

The worldwide burden of disease due to Epstein-Barr virus (EBV) infection is enormous. Diseases include endemic Burkitt lymphoma, infectious mononucleosis, cancers after transplantation, Hodgkin lymphoma, and nasopharyngeal carcinoma. A prophylactic EBV vaccine has the potential to significantly reduce the incidence and/or the severity of all these diseases. Infectious mononucleosis can be nasty and prolonged with a median duration of 17 days. Patients, especially children, undergoing bone marrow or solid organ transplantation may develop post-transplant lymphoproliferative disorder (PTLD). Preventing or modifying primary EBV infection could reduce the incidence PTLD, and also certain lymphomas and nasopharyngeal carcinoma. EBV is a major environmental risk factor for multiple sclerosis (MS). Contracting EBV is essential to getting MS, and having a childhood case of infectious mononucleosis increases that risk. Vaccinating against EBV could be vaccinating against MS.

Combining mTor inhibitors with rapamycin-resistant T cells: a two-pronged approach to tumor elimination.

Despite activity as single agent cancer therapies, Rapamycin (rapa) and its rapalogs may have their greatest effects when combined with other therapeutic modalities. In addition to direct antitumor activity, rapalogs reverse multiple tumor-intrinsic immune evasion mechanisms. These should facilitate tumor-specific T cell activity, but since rapa directly inhibits effector T cells, this potential immune enhancement is lost. We hypothesized that if T cells were rendered resistant to rapa they could capitalize on its downregulation of tumor immune evasion. We therefore modified T cells with a rapa-resistant mutant of mTor, mTorRR, and directed them to B lymphomas by coexpressing a chimeric antigen receptor (CAR) for CD19 (CAR.CD19-28ζ). T cells expressing transgenic mTorRR from a piggyBac transposon maintain mTor signaling, proliferate in the presence of rapa and retain their cytotoxic function and ability to secrete interferon-γ (IFNγ) after stimulation, effector functions that were inhibited by rapa in control T cells. In combination, rapa and rapa-resistant-CAR.CD19-28ζ-expressing T cells produced greater antitumor activity against Burkitt's lymphoma and pre-B ALL cell lines in vitro than CAR.CD19-28ζ T cells or rapa alone. In conclusion, the combination of rapa and rapa-resistant, CAR.CD19-28ζ-expressing T cells may provide a novel therapy for the treatment of B cell malignancies and other cancers.

Antimalarial therapy prevents Myc-induced lymphoma.

The two modes of self-destruction at the cellular level - apoptosis (self-killing) and autophagy (self-eating) - are thought to be tumor suppressive. In particular, germline loss of function of genes involved in autophagy has been associated with tumorigenesis. However, recent studies, including the one by Maclean et al. reported in this issue of the JCI, indicate that autophagy can provide a means for cell survival when nutrients are limiting, such that inhibition of autophagy by the antimalarial drug chloroquine can inhibit tumorigenesis, specifically Myc-induced lymphoma in mice (see the related article beginning on page 79). These findings suggest that a new use of an old drug for cancer prevention may profoundly affect disease outcome.

Targeting lysosomal degradation induces p53-dependent cell death and prevents cancer in mouse models of lymphomagenesis.

Despite great interest in cancer chemoprevention, effective agents are few. Here we show that chloroquine, a drug that activates the stress-responsive Atm-p53 tumor-suppressor pathway, preferentially enhances the death of Myc oncogene-overexpressing primary mouse B cells and mouse embryonic fibroblasts (MEFs) and impairs Myc-induced lymphomagenesis in a transgenic mouse model of human Burkitt lymphoma. Chloroquine-induced cell death in primary MEFs and human colorectal cancer cells was dependent upon p53, but not upon the p53 modulators Atm or Arf. Accordingly, chloroquine impaired spontaneous lymphoma development in Atm-deficient mice, a mouse model of ataxia telangiectasia, but not in p53-deficient mice. Chloroquine treatment enhanced markers of both macroautophagy and apoptosis in MEFs but ultimately impaired lysosomal protein degradation. Interestingly, chloroquine-induced cell death was not dependent on caspase-mediated apoptosis, as neither overexpression of the antiapoptotic protein Bcl-2 nor deletion of the proapoptotic Bax and Bak affected chloroquine-induced MEF death. However, when both apoptotic and autophagic pathways were blocked simultaneously, chloroquine-induced killing of Myc-overexpressing cells was blunted. Thus chloroquine induces lysosomal stress and provokes a p53-dependent cell death that does not require caspase-mediated apoptosis. These findings specifically demonstrate that intermittent chloroquine use effectively prevents cancer in mouse models of 2 genetically distinct human cancer syndromes, Burkitt lymphoma and ataxia telangiectasia, suggesting that agents targeting lysosome-mediated degradation may be effective in cancer prevention.

IL-21-mediated potentiation of antitumor cytolytic and proinflammatory responses of human V gamma 9V delta 2 T cells for adoptive immunotherapy.

Vgamma9Vdelta2 T lymphocytes are a major human gammadelta T cell subset that react against a wide array of tumor cells, through recognition of phosphorylated isoprenoid pathway metabolites called phosphoantigens. Immunotherapeutic protocols targeting Vgamma9Vdelta2 T cells have yielded promising, yet limited, signs of antitumor efficacy. To improve these approaches, we analyzed the effects on gammadelta T cells of IL-21, a cytokine known to enhance proliferation and effector functions of CD8(+) T cells and NK cells. IL-21 induced limited division of phosphoantigen-stimulated Vgamma9Vdelta2 T cells, but did not modulate their sustained expansion induced by exogenous IL-2. Vgamma9Vdelta2 T cells expanded in the presence of IL-21 and IL-2 showed enhanced antitumor cytolytic responses, associated with increased expression of CD56 and several lytic molecules, and increased tumor-induced degranulation capacity. IL-21 plus IL-2-expanded Vgamma9Vdelta2 T cells expressed higher levels of inhibitory receptors (e.g., ILT2 and NKG2A) and lower levels of the costimulatory molecule NKG2D. Importantly, these changes were rapidly and reversibly induced after short-term culture with IL-21. Finally, IL-21 irreversibly enhanced the proinflammatory Th1 polarization of expanded Vgamma9Vdelta2 T cells when added at the beginning of the culture. These data suggest a new role played by IL-21 in the cytotoxic and Th1 programming of precommitted Ag-stimulated gammadelta T cells. On a more applied standpoint, IL-21 could be combined to IL-2 to enhance gammadelta T cell-mediated antitumor responses, and thus represents a promising way to optimize immunotherapies targeting this cell subset.

Cancer Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda.

Background: Research into aetiologies and prevention of the commonest cancers and implementation of primary and secondary prevention can reduce cancer risk and improve quality of life. Moreover, monitoring the prevalence of cancer risk factors in a specific population helps guide cancer prevention and early detection efforts and national cancer control programming. Objective: This article aims to provide the scope and findings of cancer risk studies conducted in Uganda to guide researchers, health-care professionals, and policymakers. Methods: Between November 2019 to January 2020, we searched peer-reviewed published articles in Pubmed, EMBASE and Cochrane Library (Cochrane central register of controlled trials-CENTRAL). We followed the recommendation of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - the PRISMA. The primary focus was to identify cancer risk and prevention studies conducted in Uganda and published in peer-reviewed journals from January 2000 and January 2020. We used key Boolean search terms with their associated database strings. Results: We identified 416 articles, screened 269 non-duplicate articles and obtained 77 full-text articles for review. Out of the 77 studies, we identified one (1%) randomized trial, two (2.5%) retrospective cohort studies and 14 (18%) case-control studies, 46 (60%) cross-sectional studies, five (6.4%) ecological studies, three panel studies (4%) and six (8%) qualitative studies. Cervical cancer was the most studied type of cancer in Uganda (23.4%, n = 18 studies), followed by lymphomas - both Hodgkin and Non-Hodgkin sub-types (20.7%), n = 16 studies) and breast cancer (15.6%, n = 12 studies). In lymphoma studies, Burkitt lymphoma was the most studied type of lymphoma (76%, n = 13 studies). The studies concentrated on specific cancer risk awareness, risk perceptions, attitudes, uptake of screening, uptake of human papillomavirus vaccination, the prevalence of some of the known cancer risk factors and obstacles to accessing screening services. Conclusion: The unmet need for comprehensive cancer risk and prevention studies is enormous in Uganda. Future studies need to comprehensively investigate the known and putative cancer risk factors and prioritize the application of the higher-hierarchy evidence-generating epidemiological studies to guide planning of the national cancer control program.

Construction of Epstein-Bar virus cocktail peptide fused with Fcγ of IgG: as a potential delivery system for vaccine development.

Epstein-Barr virus (EBV) associated with several diseases such as contagious mononucleosis chronic active EBV infection, and diverse sorts of malignant tumors. Therefore, using applicable vaccines could be advantageous for public health. Yet, the vaccine has been unavailable to protect from EBV so far. In the current study, to develop a multi-peptide vaccine for EBV and assess its expression in Pichia pastoris yeast system, three immunodominant sequences in glycoprotein (gp) 85, gp350 and latent membrane protein 1 (LMP1) were chosen. To construct fusion peptide, -GGGGS- liker was applied. After cloning the fusion peptide in the pPICZαA expression vector, this recombinant vector processed and transfected into Pichia pastoris host cells. The expression of high level of EBV fusion peptide was confirmed by dot blot and SDS-PAGE procedures. The Pichia pastoris is capable of supporting EBV fusion peptide expression. The application of this fusion peptide as a peptide vaccine to fight EBV is suggested.

Ethyl acetate extract of Clausena execavata promotes growth inhibition of Burkitt's lymphoma cell line via apoptotic activities / El extracto de acetato de etilo de Clausena excavata promueve la inhibición del crecimiento de la línea celular del linfoma de Burkitt a través de actividades apoptóticas

Clausena excavata is a famous folklore medicinal plant in Asian region that is being used for the treatment of different disorders. This study investigated the cytotoxic effects of leaf extracts via MTT assay, as well as the in vitro apoptotic activities of the ethyl acetate C. excavata leaf extract (EACE) on human Burkitt's lymphoma, Raji, cell line using annexin-V-FITC/propidium iodide flow cytometric assays. Pro-apoptotic (BAX) and anti-apoptotic (BCL-2, c-MYC) gene expressions were determined via real-time quantitative PCR. Phytochemical screening was done by Gas chromatography-mass spectrometry (GC-MS). EACE has the lowest IC50 (19.3 ± 0.35 µg/mL) among extracts. EACE-treated Raji cells after 48 h underwent apoptosis as evident by loss of cell viability and increase in the percentage of early and late apoptotic cells. The results also showed EACE mediated decreased in the BCL-2 and c-MYC gene expressions and increased in the BAX gene. C. excavata is a potential treatment for Burkitt lymphoma through activation of apoptosis.

Clausena excavata es una planta medicinal tradicional famosa en la región asiática que se utiliza para el tratamiento de diferentes trastornos. Este estudio investigó los efectos citotóxicos de los extractos de hojas a través del ensayo MTT, así como las actividades apoptóticas in vitro del extracto de hoja de acetato de etilo de C. excavata (EACE) en la línea celular de linfoma de Burkitt humano, Raji, usando citometría de flujo de yoduro de anexina-V-FITC/propidio. Las expresiones génicas proapoptóticas (BAX) y antiapoptóticas (BCL-2, c-MYC) se determinaron mediante PCR cuantitativa en tiempo real. El cribado fitoquímico se realizó mediante cromatografía de gases-espectrometría de masas (GC-MS). EACE tiene el IC50más bajo (19,3 ± 0,35 µg/mL) entre los extractos. Las células Raji tratadas con EACE después de 48 h sufrieron apoptosis como es evidente por la pérdida de viabilidad celular y el aumento en el porcentaje de células apoptóticas tempranas y tardías. Los resultados también mostraron una disminución mediada por EACE en las expresiones de los genes BCL-2 y c-MYC y un aumento en el gen BAX. C. excavata es un tratamiento potencial para el linfoma de Burkitt a través de la activación de la apoptosis.

Synergistic Protective Effect of Sickle Cell Trait and Blood Group-O on the Risk of Endemic Burkitt's Lymphoma.

BACKGROUND: Previous research strongly suggest that malaria is an important factor in the pathogenesis of endemic Burkitt's lymphoma (eBL). Therefore, genetic factors such as sickle cell trait (SCT) and blood group-O that offer protection against severe malaria would be expected to reduce the risks of eBL. However, previous reports on the protective roles of SCT and blood group-O against the risks of eBL were inconclusive. Hence, the need for further studies on the protective roles of SCT and blood group-O separately, and also to investigate whether or not the combined anti-severe malaria protective roles of SCT and blood group-O have synergistic effects in reducing the risks of eBL. We therefore hypothesize that SCT and blood group-O are independently associated with reduced risks of eBL, and the co-inheritance of both factors (SCT and group-O) would provide greater protection against eBL. If our hypothesis is correct, children who inherited both SCT and blood group-O would have lower risks of eBL than their counterparts who inherited SCT or blood group-O separately. To the best of our knowledge, the possible synergistic relationship between SCT and blood group-O with regards to the risk of eBL has not been previously studied. PATIENTS AND METHODS: We conducted a retrospective logistic regression analysis of the frequencies of Hb phenotypes and ABO blood groups among patients with eBL in order to determine the separate and synergistic protective effects of SCT and blood group-O on the risk of eBL in Nigeria where eBL is among the most common malignant childhood cancers. RESULTS: The Odd Ratios (OR) for the risk of eBL were 0.52 for 'SCT irrespective of ABO blood group'; 0.49 for 'blood group-O irrespective of Hb phenotype'; and 0.23 for 'SCT with blood group-O'. DISCUSSION: These values suggest that both SCT and blood group-O are independently associated with modest reduction in the risk of eBL. However, when SCT with blood group-O was assessed for the risk factor for eBL, we obtained an Odds ratio of 0.23, which was significantly lower than the OR values for SCT (0.52) and blood group-O (0.49) separately. These figures suggest that coinheritance of SCT and blood group-O offers greater reduction in the risk of eBL than that provided by either SCT or blood group-O separately. The greater protection against eBL provided by the coinheritance of SCT and blood group-O is interpreted to be the resultant synergistic effect of the combined anti-malarial attributes of SCT and blood group-O. CONCLUSION: These findings suggest that the combined anti-malarial protective roles of SCT and blood group-O have synergistic effects in reducing the risks of eBL. This study has provided further evidence on the association between malaria-protective genetic polymorphisms and eBL, which is consistent with the aetiologic role of malaria in the pathogenesis of the tumour. Hence, the need for malaria endemic countries to intensify malaria control programs in order to curtail the incidence of eBL.

Thioredoxin overexpression in mice, model of attenuation of oxidative stress, prevents benzene-induced hemato-lymphoid toxicity and thymic lymphoma.

OBJECTIVE: Reactive oxygen species (ROS), generated following benzene exposure, are considered to trigger the development of hematopoietic neoplasms, although little supporting evidence has been found. In this study, we examined whether the experimental elimination of ROS generated following benzene exposure prevents the development of benzene-induced hematopoietic disorders to clarify the mechanism underlying the development of benzene-induced hematopoietic disorders. METHODS: C57BL/6 mice, overexpressing human thioredoxin (h-Trx-Tg), were used to examine the possible nullification of ROS induction following benzene exposure. The experimental group was exposed to 300 ppm benzene 6 hours/day, 5 days/week, for 26 weeks, and lifetime observation followed by molecular and histopathological examinations were carried out. RESULTS: The present study using h-Trx-Tg mice showed a complete suppression of the development of thymic lymphoma induced by benzene inhalation (0% in h-Trx-Tg vs 30% in wild-type (Wt) mice). This was associated with a 48% decrease in the incidence of clastogenic micronucleated reticulocyte induction in the h-Trx-Tg mice compared with the Wt control after 2 weeks of inhalation. As underlying mechanisms, the attenuation of oxidative stress was accompanied by a complete abrogation of hemato-lymphoid toxicity, as shown by the upregulation of the activity of superoxide-dismutase, and a consequently stable ROS level, as determined by cell sorting using 2', 7'-dichlorodihydrofluorescein diacetate, along with a significant attenuation of the overexpression of a cell cycle-dependent kinase inhibitor, p21. CONCLUSION: The attenuation of benzene-induced oxidative stress and that of the consequent lymphomagenesis were observed for the first time, and these indicate a role of oxidative stress in benzene-induced clastogenesis and lymphomagenesis. (These attenuations were not seen in nonthymic lymphomas, and no leukemias developed in C57BL/6 used in this study.) During the constitutive overexpression of h-Trx, the expression of aryl-hydrocarbon receptor in h-Trx-Tg mice was downregulated, which may also contribute to the attenuation.

Analysis of the role of intratecal liposomal cytarabine in the prophylaxis and treatment of central nervous system lymphomatosis: The Balearic Lymphoma Group experience.

Central nervous system (CNS) lymphomatosis is a fatal complication of aggressive non-Hodgkin lymphoma (NHL). In lymphoblastic or Burkitt lymphoma, without specific CNS prophylaxis the risk of CNS relapse is 20-30%. DLBCL has a lower risk of relapse (around 5%) but several factors increase its incidence. There is no consensus or trials to conclude which is the best CNS prophylaxis. Best results seem to be associated with the use of intravenous (iv) high-dose methotrexate (HDMTX) but with a significant toxicity. Other options are the administration of intrathecal (IT) MTX, cytarabine or liposomal cytarabine (ITLC). Our aim is to analyze the experience of the centers of the Balearic Lymphoma Group (BLG) about the toxicity and efficacy of ITLC in the prophylaxis and therapy of CNS lymphomatosis. We retrospectively reviewed cases from 2005 to 2015 (n = 58) treated with ITLC. Our toxicity results were: 33% headache, 20% neurological deficits, 11% nausea, 9% dizziness, 4% vomiting, 4% fever, 2% transient blindness and 2% photophobia. In the prophylactic cohort (n = 26) with a median follow-up of 55 months (17-81) only 3 CNS relapses (11%) were observed (testicular DLBCL, Burkitt and plasmablastic lymphoma, with a cumulative incidence of 8%, 14% and 20% respectively). In the treatment cohort (n = 32), CSF complete clearance was obtained in 77% cases. Median OS was 6 months (0-16). Death causes were lymphoma progression (19 patients, 79%), treatment toxicity (2 patients) and non-related (3 patients, 12%). Toxicity profile was good especially when concomitant dexamethasone was administered. In the prophylactic cohort the incidence of CNS relapse in DLBCL group was similar to previously reported for HDMTX and much better than IT MTX. A high number of ITLC injections was associated with better rates of CSF clearance, clinical responses, PFS and lower relapses. Survival is still poor in CNS lymphomatosis and new therapeutic approaches are still needed.

Implications of a vaccine for the prevention of Epstein-Barr virus infection: ethical and logistic considerations.

Reasons are given for considering that there is sufficiently substantial indirect and circumstantial evidence linking Epstein-Barr (EB) virus to African Burkitt's lymphoma (BL) and nasopharyngeal carcinoma to call for a dynamic new approach to establish a causal role for the virus in these human cancers. It would seem that the only way to do this would be to develop a vaccine, vaccinate a population at risk in a high-tumor-incidence area, and subsequently follow the population for a consequential decrease in tumor incidence. Recent developments in the control of animal herpesvirus-induced malignant tumors by vaccines free of viral nucleic acid make it possible to envisage that a similar vaccine could be developed against EB virus without undue difficulty. Experiments showing the tumor-inducing ability of EB virus in South American subhuman primates have provided an in vivo laboratory system in which to test the safety and efficacy of the vaccine. Trial of the vaccine in human populations could be carried out by testing its ability to protect those at risk from primary EB virus infection accompanied by infectious mononucleosis. Although in world terms BL is not a major health problem, nevertheless African BL provides uniquely favorable conditions in which to test for a causative role for EB virus: high incidence areas are known, the peak tumor incidence is at the age of 5 or 6, and the effects of vaccination on tumor incidence could be assessed within a decade. Should a carcinogenic role for EB virus be demonstrated in African BL, a much longer term program would be called for to extend the vaccine control of infection to areas where EB virus is implicated in the induction of nasopharyngeal carcinoma. Although a high incidence of this tumor is confined to populations of Southern Chinese origin, the very large numbers of such people and the frequency of the tumor among them make this a substantial world health problem and, therefore, worth the cost and effort necessary to develop a vaccine giving life-long immunity and to conduct a program that will take more than a generation to give positive results.

Epstein-Barr virus behavior in different populations and implications for control of Epstein-Barr virus-associated tumors.

The epidemiology of Epstein-Barr virus (EBV) infection in populations at different risk for EBV-associated diseases indicates significant differences between the populations. EBV infection takes place much earlier in Uganda, where all children are infected before the age of 2 to 3 years, than in Southeast Asia, where nasopharyngeal carcinoma is prevalent. It is proposed that such early infection in Equatorial Africa is related to the risk for Burkitt's lymphoma. Four possible interventions to control EBV-associated diseases are presented: (a) simple hygienic measures to delay natural primary infection by EBV; (b) EBV vaccine; (c) intervention against cofactors such as malaria in Burkitt's lymphoma; and (d) characterization of high-risk groups to allow early detection and successful treatment.

Growth inhibition of human cancer metastases by camptothecins in newly developed xenograft models.

Several metastatic models have been developed using clonal selection of human malignant cells metastasizing into a specific organ in NIH-I Swiss immunodeficient mice. The organs of choice were the central nervous system (CNS), targeted by metastases of malignant melanoma, and the liver, with metastases of colon adenocarcinoma. Additional models of adrenal metastases by malignant melanoma, and CNS involvement by implanted human lung squamous carcinoma or lymphoblastoid cells, are also available. Organ metastases, as well as the effects of treatment, were confirmed by autopsies and histological examination of the tissues or by a surgical inspection of the liver. The treatment end points were established as the increases in survival times of treated mice relative to placebo-treated controls. Camptothecins injected i.m. or delivered via gastrointestinal tract inhibit the growth of CNS metastases and increase the survival of treated animals. 9-Amino-20(S)-camptothecin was effective in the CNS model and in the model of liver metastases. The drug increased 3.3- and 5.7-fold the survival rates relative to untreated controls with metastases of colon adenocarcinoma to the liver, and all camptothecins were significantly more effective than 5-fluorouracil, currently a drug of choice in treatment of this disease. The xenograft models of metastases are available for studies of drug passage through the blood-brain barrier optimization of drug delivery to the liver, and for the development of new camptothecin-based treatment strategies.

Epstein-Barr virus infection of HIV-seropositive individuals is transiently suppressed by high-dose acyclovir treatment.

OBJECTIVE: To assess whether oral acyclovir can eliminate persistent Epstein-Barr virus (EBV) infection and thereby prevent EBV-associated lymphoma development in HIV-seropositive homosexual men. METHOD: Persistent EBV infection was examined in a group of 21 HIV-seropositive homosexual men before, during and after treatment with oral acyclovir at a dose of 800 mg every 6 h (10 individuals) or with a placebo (11 individuals). RESULTS: In 13 individuals, EBV was isolated from the oropharynx before and after treatment (seven cases from the acyclovir-treated group and six from the placebo-treated group). A significant reduction in virus isolation occurred during treatment in the acyclovir-treated group, but not in the placebo-treated group. In seven cases in whom EBV shedding was detected before and after treatment, the EBV strain isolated was identical throughout the study, even when acyclovir had abolished detectable shedding for the duration of the treatment. In two other cases more than one strain was detected. On examination of the EBV type present, 89% of a group of 18 patients consistently shed type A virus, 5.5% type B virus and 5.5% showed evidence of co-infection with both virus types. This compares with figures of 100, 0 and 0%, respectively, in a control group of HIV-seronegative individuals. CONCLUSIONS: High-dose acyclovir therapy does not eliminate persistent EBV infection from the oropharynx of healthy HIV-seropositive individuals and therefore would not necessarily prevent lymphoma development. Our results suggest that infection by type B EBV, and co-infections of both A and B type, are more common in HIV-seropositives than HIV-seronegatives.

Investigation of the effect of BB-94 (batimastat) on the colonization potential of human lymphoma cells in SCID mice.

We have assessed the effectiveness of the metalloproteinase inhibitor BB-94 (batimastat) in reducing the colonization potential of the human Burkitt lymphoma Namalwa cell line. In this study Namalwa cells were injected intraperitoneally into SCID mice and their spread to the spleen, liver and lung studied over a 3 week period. The human cells were detected in the mouse tissues by polymerase chain reaction (PCR) amplification of a human alu repeat sequence. Comparison of BB-94-treated animals with an untreated control group provided no evidence for a significant reduction in the colonization of mouse tissues by the human lymphoma cells in the presence of the drug. Tumour growth, after subcutaneous injection of the Namalwa cells into SCID mice, was similarly unaffected by BB-94. The significance of these results is discussed.

Clonal diversity of Ig and T-cell receptor gene rearrangements in childhood B-precursor acute lymphoblastic leukaemia.

The majority of paediatric B precursor acute lymphoblastic leukaemias in children are derived from a single transformed haematopoietic cell with complete or partial VDJ recombination within the immunoglobulin heavy chain gene. A high frequency of patients also show rearrangements within TCRdelta and TCRgamma loci and in up to 40% of children there is an excess of immune system gene rearrangements compared with the number of identified alleles of immune system genes, suggesting the presence of multiple leukaemic subclones -clonal diversity. It has been observed by us and other investigators that in individual patients the pattern of immune system gene rearrangements often changes between presentation and relapse. In order to explore the possibility that clonal diversity plays a biological role during disease progression we optimised methods for subclone detection and analysed the prognostic significance of clonal diversity among 75 children with B precursor-ALL. Our results suggest that clonal diversity plays a role in disease progression as patients with oligoclonal disease showed a significantly shorter disease free survival than patients with monoclonal disease. This trend was of particular importance in the 'standard risk' group of ALL where aggressive disease could not be recognised by other means. In addition, generation of independent subclones from an early, non-rearranged tumour progenitor appears to be a common feature among leukaemias with aggressive clinical behaviour. We speculate on the type of genetic factors which may participate both in the generation of subclones and also in wider genomic instability and which are likely to be required for the aggressive clinical phenotype in children with ALL.

Newer knowledge in comparative virology--its contribution to human health research.

Like other comparative sciences, and despite its recent beginning comparative virology has already contributed useful applications and observations to human health research. Teachings derived from the study of Marek's disease found application in that of Burkitt's lymphoma, and may lead to a possible vaccine against the human disease. Equally useful information came from the study of canine distemper in the development of a chorio-allantoic membrane attenuated measles vaccine, and in our knowledge of subacute sclerosing panencephalitis (SSPE) of humans; from the study of reovirus-like agents of infant mice and neonatal calves in that of an acute nonbacterial gastro-enteritis of infants and young children; and from that of the cancer-producing viruses of chickens, cats, and dogs to a better understanding of some human neoplasias. Finally, Aleutian mink disease may be an excellent natural model for the study of the collagen diseases of man, and scrapie of sheep one for that of a human chronic degenerative disease of the central nervous system of humans such as Kuru. Comparative virology has proved quite productive in a relatively short period, and is unlikely to be neglected in the future.